SM: Bilirubin toxicity in the developing nervous system

Bilirubin toxicity remains a significant problem despite recent advances in the care of jaundiced (hyperbiliru-binemic) neonates. A recent surge in reported cases of classical kernicterus, due in part to earlier hospital discharge and relaxation of treatment criteria for hyperbilirubinemia, and new reports of hyperbiliru-binemia-induced auditory dysfunction using evoked potential based infant testing and hearing screening, underscore the need to better understand how hyper-bilirubinemia causes brain damage in some infants, especially because the damage is preventable. Recent progress in understanding bilirubin binding and neu-rotoxicity resulting from unbound or “free ” unconju-gated bilirubin, how bilirubin affects the central ner-vous system in vivo and in vitro, and the use of ne