The reversed feto-maternal bile acid gradient in intrahepatic cholestasis of pregnancy is corrected by ursodeoxycholic acid.
The reversed feto-maternal bile acid gradient in intrahepatic cholestasis of pregnancy is corrected by ursodeoxycholic acid.
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DOI：
10.1371/journal.pone.0083828
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Williamson C
中科院分区：
文献类型：
--
作者：
Geenes V;Lövgren-Sandblom A;Benthin L;Lawrance D;Chambers J;Gurung V;Thornton J;Chappell L;Khan E;Dixon P;Marschall HU;Williamson C
妊娠肝内胆汁淤积症（ICP）是一种妊娠特异性肝脏疾病，与胎儿不良结局的风险增加有关。其特点是母体血清胆汁酸升高，这被认为会导致不良后果。ICP常用熊去氧胆酸（UDCA）治疗。本研究旨在确定正常妊娠和ICP妊娠的胎儿和母亲胆汁酸谱，并检查UDCA治疗的效果。从未治疗的ICP （n = 18）、udca治疗的ICP （n = 46）和分娩时无并发症的妊娠（n = 15）患者中收集匹配的母体和脐带血清样本。采用HPLC-MS/MS对19种胆汁酸进行测定。与正常妊娠相比，ICP孕妇和胎儿血清胆汁酸显著升高（p分别<0.0001和<0.05），主要是由于共轭胆酸和鹅去氧胆酸水平升高。主要胆汁酸种类的脐带动脉和脐带静脉水平没有差异。胆汁酸的胎母梯度在ICP中是相反的。UDCA治疗可显著降低产妇室血清胆汁酸（p = <0.0001），从而降低胎母经胎盘梯度。udca治疗不会引起临床上重要的石胆酸（LCA）浓度升高。ICP与母体和胎儿胆汁酸池的显著定量和定性变化有关。UDCA治疗可降低两房室胆汁酸水平，逆转质变。我们没有发现证据支持UDCA治疗使胎儿LCA浓度增加到有害水平的建议。
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder associated with an increased risk of adverse fetal outcomes. It is characterised by raised maternal serum bile acids, which are believed to cause the adverse outcomes. ICP is commonly treated with ursodeoxycholic acid (UDCA). This study aimed to determine the fetal and maternal bile acid profiles in normal and ICP pregnancies, and to examine the effect of UDCA treatment. Matched maternal and umbilical cord serum samples were collected from untreated ICP (n = 18), UDCA-treated ICP (n = 46) and uncomplicated pregnancy (n = 15) cases at the time of delivery. Nineteen individual bile acids were measured using HPLC-MS/MS. Maternal and fetal serum bile acids are significantly raised in ICP compared with normal pregnancy (p = <0.0001 and <0.05, respectively), predominantly due to increased levels of conjugated cholic and chenodeoxycholic acid. There are no differences between the umbilical cord artery and cord vein levels of the major bile acid species. The feto-maternal gradient of bile acids is reversed in ICP. Treatment with UDCA significantly reduces serum bile acids in the maternal compartment (p = <0.0001), thereby reducing the feto-maternal transplacental gradient. UDCA-treatment does not cause a clinically important increase in lithocholic acid (LCA) concentrations. ICP is associated with significant quantitative and qualitative changes in the maternal and fetal bile acid pools. Treatment with UDCA reduces the level of bile acids in both compartments and reverses the qualitative changes. We have not found evidence to support the suggestion that UDCA treatment increases fetal LCA concentrations to deleterious levels.
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影响因子：
3.8
作者：
Geenes, V. L.;Lim, Y. -H.;Williamson, C.
通讯作者：
Williamson, C.
影响因子：
29.4
作者：
LUNZER, M;BARNES, P;OHALLORAN, M
通讯作者：
OHALLORAN, M
影响因子：
29.4
作者：
Bacq, Yannick;Sentilhes, Loic;Di Martino, Vincent
通讯作者：
Di Martino, Vincent
DOI：
10.1016/s0002-9378(16)32430-9
发表时间：
1982-01-01
影响因子：
9.8
作者：
SHAW, D;FROHLICH, J;WILLMS, M
通讯作者：
WILLMS, M
影响因子：
105.7
作者：
Chappell, Lucy C.;Gurung, Vinita;Thornton, James G.
通讯作者：
Thornton, James G.