Human conjugated bilirubin--isolation, biosynthesis, and direct molecular characterization.

We prepared human conjugated bilirubin by isolation from fresh gall bladder bile and by biosynthesis using liver homogenates. The isolation protocol was modified after Lucassen (doctoral thesis, Univ. Utrecht, 1961), and the in vitro synthesis was done with fresh liver homogenates in the presence of D-glucaro-1,4-lactone (a glucuronidase inhibitor). From direct analyses of these preparations with 270-MHz proton nuclear magnetic resonance and field-desorption mass spectrometry, we deduced that a major conjugated bilirubin species in bile is a diglucuronide, whereas in liver biosynthesis it is a diconjugate containing glucuronic acid and possibly glucuronolactone co-esterified to the bilirubin backbone. If the glucuronolactone is indeed present in the native biosynthetic material, we do not know whether it derives from glucuronic acid and, if so, whether lactonization occurs before or after the acid has been esterified to form the conjugate.