Is kernicterus due to inhibition of brain hexose-monophosphate shunt activity by bilirubin?
Degradation of biogenic amines in the central nervous system is accomplished by the monoamine oxidase system. The by-products of this reaction, hydrogen peroxide and amino aldehydes, are toxic to neurones. Detoxification of these by-products is normally mediated by generation of NADPH via the hexosemonophosphate (HMP) shunt. It is proposed that inhibition of the HMP shunt by unconjugated bilirubin leads to the toxic accumulation of hydrogen peroxide and aldehydes.
