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In the liver, bilirubin is conjugated with glucuronic acid by the enzyme glucuronyltransferase, first to bilirubin glucuronide and then to bilirubin diglucuronide, making it soluble in water: the conjugated version is the main form of bilirubin present in the "direct" bilirubin fraction. Much of it goes into the bile and thus out into the small ...
Bile acids have other functions, including eliminating cholesterol from the body, driving the flow of bile to eliminate certain catabolites (including bilirubin), emulsifying fat-soluble vitamins to enable their absorption, and aiding in motility and the reduction of the bacteria flora found in the small intestine and biliary tract.
Bilirubin derives from hemoglobin by glucuronidation. Bile tends to be alkaline on average. The pH of common duct bile (7.50 to 8.05) is higher than that of the corresponding gallbladder bile (6.80 to 7.65). Bile in the gallbladder becomes more acidic the longer a person goes without eating, though resting slows this fall in pH. [12]
These lipid-soluble bile acids are conjugated (reversibly attached) mainly to glycine or taurine molecules to form water soluble primary conjugated bile acids, sometimes called "bile salts". These bile acids travel to the gall bladder during the interdigestive phase for storage and to the descending part of the duodenum via the common bile duct ...
The bilirubin present in the plasma is largely unconjugated in this setting as they haven't been taken up and conjugated by the liver. [3] In this case, total serum bilirubin increases while the ratio of direct bilirubin to indirect bilirubin remains 96 to 4 as up to 96%-99% of bilirubin in the bile are conjugated mentioned above. [9] [1]
Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and conjugated bilirubin. [2] Some components are synthesized by hepatocytes (liver cells); the rest are extracted from the blood by the liver. [3] Bile is secreted by the liver into small ducts that join to form the common hepatic duct. [4]
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Bile acids Digestive function, bilirubin excretion 2-30 × 10 −6: 3-30 × 10 −6: Bilirubin: Hemoglobin metabolite 2-14 × 10 −6: 1-10 × 10 −6: Biotin (Vitamin H) Gluconeogenesis, metabolize leucine, fatty acid synthesis 7-17 × 10 −9: 9-16 × 10 −9: Blood Urea Nitrogen (BUN) 8-23 × 10 −5: Bradykinin: 7 × 10 −11: Bromide: 7-10 ...