Influence of skin optical losses on configurational photoisomerization of bilirubin during phototherapy

Kubelka-Munk theory of radiation transfer in turbid media is applied to determine the influence of skin optical losses on the efficiency of phototherapy of neonatal hyperbilirubinemia. By using a multilayer model of the skin and a rate equation analysis of bilirubin photo-isomerization, the photon absorption rates of birilubin and of its configurational photoisomers and, in turn, the photoequilibrium concentrations and rise time are calculated for spectrally Gaussian light sources and fluorescent lamps used in phototherapy. It turns out that light absorption and scattering processes in the skin layers produce a 30 nm red-shift of the optimum value of the peak excitation wave-length of bilirubin absorption and photoequilibrium rise time. The comparative data on the phototherapeutical efficiency of different spectral regionsin vivo (Gunn rats and humans) are discussed.