BLVRB (biliverdin reductase B) is a multifunctional NAD(P)H-dependent oxidoreductase with dual catalytic activities. As a biliverdin reductase, BLVRB catalyzes reduction of biliverdin IXβ to bilirubin IXβ, playing a critical role in fetal heme catabolism 1. In adults, BLVRB functions as a redox regulator controlling hematopoietic cell fate, particularly in megakaryocyte and erythroid lineage specification through ROS modulation 2. BLVRB also acts as a protein nitrosyltransferase, catalyzing S-nitrosylation of cysteine residues in target proteins including insulin receptor (INSR) and insulin receptor substrate 1 (IRS1), thereby inhibiting insulin signaling 3. Beyond hematopoiesis, BLVRB regulates intermediary metabolism pathways including glycolysis and the TCA cycle 1. Disease relevance includes pulmonary fibrosis, where BLVRB knockdown inhibits fibroblast α-SMA and collagen expression 4, and cholangiocarcinoma, where low BLVRB expression correlates with poor prognosis and increased metastatic potential through Notch/Snail pathway activation 5. BLVRB also contributes to viral pathogenesis, with involvement in Zika virus-induced lipid peroxidation and viral protein stability 3. Pharmacologically, selective BLVRB inhibitors promote megakaryocyte expansion and stress-induced platelet recovery in vivo, representing a potential therapeutic strategy distinct from thrombopoietin-dependent mechanisms 6.