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Superoxide anions may directly react with NO, thereby stimulating the production of the NO/superoxide anion reaction product peroxynitrite (ONOO ), which in turn has been shown to uncouple the endothelial nitric oxide synthase (eNOS), thereby causing an anti-atherosclerotic NO-producing enzyme to become a ROS-producing enzyme, thus accelerating the atherosclerotic process

Lakshmikuttyamma A, Pastural E, Takahashi N, Sawada K, Sheridan DP, DeCoteau JF, et al

CONCLUSIONS In spite of the evidence of the antioxidant effect of bilirubin it is important to highlight that this effect basically occurs in the serum while the most important protective mechanisms are within the tissues

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