*1.3.1 Cellular toxic effects of bilirubin*

Even though being of great clinical importance, hyperbilirubinemia neurotoxicity effects on the cellular level are not entirely understood. It has been established that the mitochondria could be the primary target of the bilirubin neurotoxicity as evidenced by uncoupling of oxidative phosphorylation. Additional effects expressed in neuronal tissue include inhibition of DNA synthesis, induction of DNA strand breakage, inhibition of protein synthesis, and changes in neurotransmitters' synthesis and function. Experiments in immature rats have shown association between hyperbilirubinemia and impaired cerebral glucose metabolism [9].
