Increased levels of unconjugated
bilirubin are neurotoxic, but the mechanism leading to neurological damage has not been completely elucidated. Innovative strategies of investigation are needed to more precisely define this pathological process. By longitudinal in vivo bioluminescence imaging, we noninvasively visualized the brain response to
hyperbilirubinemia in the MITO-Luc mouse, in which light emission is restricted to the regions of active cell proliferation. We assessed that acute
hyperbilirubinemia promotes bioluminescence in the brain region, indicating an increment in the cell proliferation rate. Immunohistochemical detection in brain sections of cells positive for both
luciferase and the microglial marker allograft inflammatory factor 1 suggests proliferation of microglial cells. In addition, we demonstrated that brain induction of bioluminescence was altered by pharmacological displacement of
bilirubin from its
albumin binding sites and by modulation of the blood-brain barrier permeability, all pivotal factors in the development of
bilirubin-induced
neurologic dysfunction. We also determined that treatment with
minocycline, an
antibiotic with anti-inflammatory and neuroprotective properties, or administration of
bevacizumab, an anti-
vascular endothelial growth factor antibody, blunts
bilirubin-induced bioluminescence. Overall the study supports the use of the MITO-Luc mouse as a valuable tool for the rapid response monitoring of drugs aiming at preventing acute
bilirubin-induced neurological dysfunction.