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Review
. 2025 Feb 27;17(2):98503.
doi: 10.4254/wjh.v17.i2.98503.

Gilbert's syndrome: The good, the bad and the ugly

Arjuna Priyadarsin De Silva  1 , Nilushi Nuwanshika  2 , Madunil Anuk Niriella  2 , Hithanadura Janaka de Silva  2
Affiliations
Review

Gilbert's syndrome: The good, the bad and the ugly

Arjuna Priyadarsin De Silva et al. World J Hepatol. .

Abstract

Gilbert's syndrome (GS) is a common hereditary condition characterized by mild increases in serum bilirubin levels due to inherited defects in bilirubin metabolism. This review, based on peer-reviewed articles spanning from 1977 to January 2024 and sourced through the PubMed platform, provides an overview of current knowledge regarding GS. Early studies primarily focused on defining the clinical and genetic characteristics of the syndrome. More recent research has delved into the genetic mechanisms underlying the reduced expression of bilirubin UDP-glucuronosyltransferase, significantly enhancing our understanding of the pathogenesis of GS. Recent studies have also investigated clinical implications of GS, including its association with metabolic associated steatotic liver disease, cardiovascular disease, mental health and mortality risk, highlighting the complex interplay between genetic factors, bilirubin metabolism, and clinical outcomes.

Keywords: Clinical implications; Drug metabolism; Genetic variations; Gilbert’s syndrome; Protective effects.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Hepatocyte showing the pathway for bilirubin metabolism. Glutathione-S-transferase is a carrier protein that assists bilirubin uptake into the cytosol of the hepatocyte. GST: Glutathione-S-transferase; Bilirubin-G: Bilirubin glucuronate; UGT1A1: UDP-glucuronosyltransferase family 1 member A1; MPR2: Multidrug resistance -associated protein 2.
See this image and copyright information in PMC

References

    1. Wagner KH, Shiels RG, Lang CA, Seyed Khoei N, Bulmer AC. Diagnostic criteria and contributors to Gilbert's syndrome. Crit Rev Clin Lab Sci. 2018;55:129–139. - PubMed
    1. Berthelot P, Dhumeaux D. New insights into the classification and mechanisms of hereditary, chronic, non-haemolytic hyperbilirubinaemias. Gut. 1978;19:474–480. - PMC - PubMed
    1. Memon N, Weinberger BI, Hegyi T, Aleksunes LM. Inherited disorders of bilirubin clearance. Pediatr Res. 2016;79:378–386. - PMC - PubMed
    1. Vítek L, Tiribelli C. Gilbert's syndrome revisited. J Hepatol. 2023;79:1049–1055. - PubMed
    1. Huppertz LM, Gunsilius L, Lardi C, Weinmann W, Thierauf-Emberger A. Influence of Gilbert's syndrome on the formation of ethyl glucuronide. Int J Legal Med. 2015;129:1005–1010. - PubMed