PEDIATRICS Vol. 81 No. 6 June 1988, pp. 882-884
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Light Versus Tin?

M. JEFFREY MAISELS MB, BCH1

1 Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI

One of the first steps in the formation of bilirubin from hemoglobin is an oxidative process in which the agr-methene bridge of the heme porphyrin ring is opened and carbon monoxide and bilirubin are formed. This oxidation is catalyzed by the enzyme microsomal heme oxygenase. Following earlier observations from their laboratory, Drummond and Kappas1 demonstrated that tin protoporphyrin (Sn-protoporphyrin) was the most potent of several synthetic metalloporphyrins that competitively inhibited heme oxygenase. By competing with this enzyme, Sn-protoporphyrin inhibits the conversion of heme to bilirubin and is effective in preventing or ameliorating experimental and naturally occurring jaundice in the neonatal animal and adult human.