“…These bilirubin oxidative metabolites (BOM) in urine were found to increase in a patient who had undergone laparotomy that had taken a long time (Yamaguchi et al, 1994b). This result suggests that bilirubin is oxidized more by reactive oxygen species produced during laparotomy and has a protective effect against oxidative stress in viva Heme oxygenase, a rate-limiting enzyme of bilirubin biosynthesis, comprises two isozymes (Braggins et al, 1986;Trakshel and Maines, 1989;Trakshel et al, 1991;Cruse and Maines, 1988), heme oxygenase-1 (inducible) and heme oxygenase-2 (constitutive). Heme oxygenase-1 activity is significantly increased by heme, endotoxin (lipopolysaccharide, LPS), heavy metals, heat shock, interleukin-I , and hydrogen peroxide (Taketani et al, 1989;Keyse and Tyrrell, 1989;Vile and Tyrrell, 1993;Tomaro et al, 1991).…”