High levels of serum superoxide dismutase as a biomarker of intrahepatic cholestasis of pregnancy in patients with viral hepatitis B

Abstract

Background Intrahepatic cholestasis of pregnancy (ICP) is characterized by skin pruritus and impaired liver function. Hepatitis B virus (HBV) infection increases the risk of developing ICP. HBV infection is associated with oxidative stress, which has been proven to participate in the development of ICP. The goal of this study was to explore the relationship among HBV, oxidative stress, and ICP, and investigate whether a biomarker of oxidative stress may predict the diagnosis and severity of ICP. Methods We induced a retrospective cohort of 70 ICP patients from January 2019 to December 2020, and compared their data with those from healthy pregnant women (n = 70). Serum levels of an oxidative stress marker superoxide dismutase (SOD) were examined using an enzyme-linked immunosorbent assay (ELISA). Diagnostic and prognostic values of serum SOD were analyzed by receiver operating characteristic (ROC) curve. Results Pregnant women in the ICP group had significantly higher level of serum SOD (243.24 ± 12.57 U/L vs 98.70 ± 2.95 U/L, p < 0.01) and a higher rate of HBV infection (51.53% vs 25.71%, p < 0.05) compared with the control group. HBsAg-positive ICP patients had a higher levels of serum SOD (287.24 ± 19.21 U/L vs 196.65 ± 11.75 U/L, p < 0.01) compared with HBsAg-negative ICP patients. A serum SOD level > 121.4 U/mL might be used to predict ICP, while a serum SOD level > 274.6 U/mL might predict ICP severity. Conclusion HBV infection promotes oxidative stress during the pathogenesis of ICP. Serum levels of SOD could be used to predict ICP diagnosis and severity. Modification of oxidative stress might be a treatment target for ICP.

The correlation between serum total bile acid and adverse perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP) and non-ICP hypercholanemia of pregnancy

“…The presence of risk factors or co-morbidities can increase the risk of stillbirth in women with ICP, according to the ICP clinical guideline published in the British Journal of Obstetrics and Gynaecology (BJOG) in 2022 [ 18 ]. There is a lot of evidence that hepatitis increases oxidative stress during the development of hypercholanemia [ 33–35 ], which leads to higher levels of total TBA in the peripheral blood compared to ICP [ 9 , 30 , 36 ]. Therefore, in patients who have TBA ≥100µmol/L and also have liver disease, excessive TBA concentrations and liver disease could work together to cause oxidative stress, which raises the risk of perinatal death.…”

Risk factors associated with cesarean section and adverse fetal outcomes in intrahepatic cholestasis of pregnancy

“…Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained maternal pruritus, raised serum bile acids (>10 μmol/L) and/or elevated liver transaminases (ALT > 35 U/L and/or AST > 35 U/L) during the late second and third trimester of pregnancy (1)(2)(3). Currently, the etiology of ICP is not fully understood but may be affected by hormonal, genetic, and environmental factors (4).…”