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Neonatal Hyperbilirubinemia

Am J Dis Child. 1981;135(1):87. doi:10.1001/archpedi.1981.02130250073033.
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I find it curious how advances in science may stem from ideas that ultimately turn out to be wrong. For example, in 1959 Arthur Kornberg won the Nobel Prize, in part for his discovery of DNA polymerase. Sometimes called the Kornberg enzyme, DNA polymerase was thought to direct the replication of DNA within chromosomes. Such is not true, as Kornberg himself will tell you in a recently published monograph. Yet this fact detracts not one whit from the herculean accomplishments that followed from Kornberg's original concept.

Gerard Odell published several germinal papers on bilirubin in that same year, 1959. He emphasized the hypothesis that has dominated research on bilirubin since then: the free bilirubin theory. In its essence, the theory proposes the following: (1) Albumin-bound bilirubin cannot enter the brain, being excluded by the blood-brain barrier. (2) Unbound bilirubin is a hydrophobic, lipid-soluble substance that sees no blood-brain barrier. (3)


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