Expression of urocortin and corticotrophin-releasing hormone receptor-2 in patients with intrahepatic cholestasis of pregnancy

Zhang, Fan; Zhang, L.; Sun, Qiang; Wang, X.D.

doi:10.1016/j.placenta.2014.07.019

Cited by 10 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Corticotropin-releasing hormone (CRH) and urocortin (UCN) are vasodilatory regulators of blood flow in the placenta. Downregulated UCN expression in ICP has been reported by several groups [ 43 – 45 ]. The study by Xu et al also showed that the transcription and translation of UCN changed during the process of ICP in early pregnancy [ 46 ].…”

Section: The Role Of Hypoxiamentioning

confidence: 88%

Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

Xiao

Zhu

Song

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disease. The maternal symptoms are characterized by skin pruritus and elevated bile acids, causing several adverse outcomes for fetuses, including an increased risk of preterm birth, meconium-stained amniotic fluid, neonatal depression, respiratory distress syndrome, and stillbirth. Genetic, hormonal, immunological, and environmental factors contribute to the pathogenesis of ICP, and the estrogen-bile acid axis is thought to play a dominant role. The advances in the past 10 years uncover more details of this axis. Moreover, dysregulation of extracellular matrix and oxygen supply, organelle dysfunction, and epigenetic changes are also found to cause ICP, illuminating more potential drug targets for interfering with. Here, we summarize the molecular pathogenesis of ICP with an emphasis on the advancement in the past 10 years, aiming to give an updated full view of this field.

show abstract

Section: The Role Of Hypoxiamentioning

confidence: 88%

Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

Xiao

Zhu

Song

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

View full text Add to dashboard Cite

show abstract

“…The peptide binds specific CRH-R2 receptors in the placenta and in the umbilical circulation, with increased expression of nitric oxide synthase (NOS), followed by increased nitric oxide (NO) production and intense vasodilatation [ 28 ]. The “selective” effect of corticosteroids on umbilical arteries is due to the little (or no) evidence of the presence of CRH-R2 in the utero-placental circulation [ 29 ]. However, during the adult disease state (as seen in ESP), in the systemic circulation, steroids can directly and non-transcriptionally activate endothelial NOS (eNOS) and modulate its activity in a high-dose brief-exposure manner [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone on absent end-diastolic flow in umbilical artery, in growth restricted fetuses from early-onset preeclamptic pregnancies and the perinatal outcome

Tica

Doriana

et al. 2021

Annals of Medicine

View full text Add to dashboard Cite

Background Absent end-diastolic flow (AEDF) in the umbilical artery (UA) worsens the already poor prognosis of growth-restricted fetuses (GRFs) in pregnancies complicated by early-onset preeclampsia with severe features (ESP). Method We assessed the correlation between the effect of maternal dexamethasone (Dex) on AEDF in the UA and perinatal outcomes, in 59 GRFs from EPS-complicated pregnancies. The maternal outcome was also evaluated. Results The mean maternal age at inclusion was 22.4 ± 5.9 years. Dex transiently restored EDF in the UA in 38 (64.4%) cases (trAEDF group), but in 21 (35.6%) patients, the flow was persistently absent (prAEDF group). The effect lasted up to the 4th day. The gestational age at diagnosis, number of days from admission until delivery, and fetal weight were significantly lower in the prAEDF group than in the trAEDF group ( p < .05). The same group had a significantly increased rate of fetal proximal deterioration, low APGAR scores, neonatal hypoxia, assisted ventilation, mild intraventricular haemorrhage (I/II), and respiratory distress syndrome, as well as maternal deterioration, especially in cases of resistant hypertension ( p < .05). Although the rates of fetal acidemia and perinatal mortality in the prAEDF group were respectively three times and two times higher, the differences were not significant ( p > .05). Conclusions The Dex no-effect on UA Doppler in GRFs with AEDF in the UA, in EPS-complicated pregnancies, can be a useful marker for a higher risk of proximal fetal deterioration, poor state at delivery, neonatal hypoxic complications, and worsening maternal condition, but not for perinatal mortality. The findings also highlight the alarmingly younger age of patients with EPS. Finally, all these pregnancies should be monitored in a complex multidisciplinary manner in tertiary referral units. Key message The effect of dexamethasone on absent end-diastolic flow in the umbilical artery in growth-restricted fetuses from pregnancies complicated by early-onset preeclampsia with severe features can be a useful prognostic factor for perinatal outcomes.

show abstract

“…Up-regulation of CRH expression was used in treatment with UDCA in patients with ICP. The diagnosis of certain forms of hepatic impairment is a challenge due to either incomplete diagnostic criteria or specific criteria that overlap in several clinical conditions [17][18][19][20][21][22] (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…In the diagnosis of ICP and laboratory markers, a series of new genetic markers have been proposed, with potential clinical utility. In ICP, some biomarkers are used for a correct diagnosis (long noncoding RNA, neopterin, maternal urinary mRNAs, and native thiol) and others in the evaluation of the treatment (CRH) [17][18][19][20][21][22] (Table 3).…”

Section: Intrahepatic Cholestasis Of Pregnancymentioning

confidence: 99%

State of the Art in Hepatic Dysfunction in Pregnancy

et al. 2021

View full text Add to dashboard Cite

Hepatic dysfunction in pregnant women is always challenging for the obstetrician, as the spectrum of hepatic abnormalities can be very large and have various implications, both for mother and fetus. There is a diagnostic and therapeutic polymorphism of hepatic dysfunction in pregnancy and insufficient knowledge related to the etiopathogenesis and epidemiology of this disease. The clinical forms of hepatic dysfunction encountered in pregnancy can vary from liver diseases related to pregnancy (e.g., HELLP syndrome, intrahepatic cholestasis, hyperemesis gravidarum, or acute fatty liver of pregnancy) to de novo ones occurring in pregnancy, and pre-existing liver disease (cholelithiasis, Budd–Chiari syndrome, and cirrhosis). We performed a systematic literature search over 10 years. The review protocol assumed a search of two databases (PubMed®/MEDLINE and Web of Science Core Collection). The strategy regarding the management of these diseases involves multidisciplinary teams composed of different specialists (obstetricians, gastroenterologists and anesthetists) from specialized tertiary centers. Despite the improving prognosis of pregnant women with liver diseases, the risk of maternal–fetal complications remains very high. Therefore, it is necessary to ensure careful monitoring by a multidisciplinary team and to inform the patients of the potential risks.

show abstract

Expression of urocortin and corticotrophin-releasing hormone receptor-2 in patients with intrahepatic cholestasis of pregnancy

Cited by 10 publications

References 22 publications

Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

Dexamethasone on absent end-diastolic flow in umbilical artery, in growth restricted fetuses from early-onset preeclamptic pregnancies and the perinatal outcome

State of the Art in Hepatic Dysfunction in Pregnancy

Contact Info

Product

Resources

About