Intrahepatic cholestasis of pregnancy: from an obstetrician point of view

Abdelhafez, Mohsen M A; Ahmed, Karim A. M.; Than, Win Win; Baharuddin, Dg Marshitah Pg; Kadir, Fairrul; Jeffree, Mohammad Saffree; Hayati, Firdaus; Daud, Mohd Nazri Bin Mohd; Eldiastey, Aya M.; Tay, Kai Xin

doi:10.1080/01443615.2022.2081801

Cited by 5 publications

(6 citation statements)

References 68 publications

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“…Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disease that usually occurs in the second or third trimester of pregnancy. Its clinical manifestations are mild to severe persistent pruritus, abnormal liver function, and elevated total bile acid (TBA) levels ( Bicocca et al, 2018 ; Abdelhafez et al, 2022 ). While maternal risks are minimal with ICP, fetal complications such as premature delivery, meconium-stained amniotic fluid, neonatal depression, respiratory distress, and stillbirth can be significant (Glantz, Marschall and Mattsson, 2004).…”

Section: Introductionmentioning

confidence: 99%

LC-MS/MS untargeted lipidomics uncovers placenta lipid signatures from intrahepatic cholestasis of pregnancy

Xiong,

Tang,

Liu

et al. 2024

Front. Physiol.

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Aims: Intrahepatic cholestasis of pregnancy (ICP) stands as the predominant liver disorder affecting pregnant women, with a prevalence ranging from 0.2% to 15.6%. While ICP is known to heighten the chances of perinatal mortality and morbidity, its pathogenesis remains elusive, and therapeutic options are limited. The objective of this study was to explore the characteristic lipid signature in placentas collected from normal pregnancies and those with mild and severe intrahepatic cholestasis of pregnancy. This research aims to clarify the pathogenesis and identify lipid biomarker for ICP through LC-MS/MS based lipidomic analysis.Methods and materials: Placenta samples were collected from 30 normal pregnancy women and 30 mild and severe ICP women respectively. Women with normal pregnancy and ICP were recruit from April 2021 to July 2022 in Chengdu, China. And LC-MS/MS based lipidomic analysis was used to explore the characteristic placental lipids in mild and severe ICP.Results: Fourty-four lipids were differentially expressed both in mild and severe ICP placenta. The pathway analysis revealed these lipids are mainly enriched in glycerophospholipid metabolism and autophagy pathway. Weighted correlation network analysis (WGCNA) identified the correlation network module of lipids highly related to ICP. Using multiple logistic regression analysis, we identified three and four combined metabolites that had an area under receiver operating characteristic curves (AUC) ≥ 0.90.Conclusion: Our results systematically revealed the lipid signature in mild and severe ICP placenta. The results may provide new insight into the treatment and early prediction of ICP.

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Section: Introductionmentioning

confidence: 99%

LC-MS/MS untargeted lipidomics uncovers placenta lipid signatures from intrahepatic cholestasis of pregnancy

Xiong,

Tang,

Liu

et al. 2024

Front. Physiol.

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“…Serum bile acid and bilirubin concentrations are positively associated with the presence of itch during cholestasis [3,[5][6][7][8]. Recently, the Mas-related G protein-coupled receptor X4 (MRGPRX4) has been identified as a bile acid and bilirubin receptor.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, in patients with intrahepatic cholestasis of pregnancy (ICP), itch is highly prevalent. In these patients, pruritus begins approximately 3 weeks before serum bile acids are elevated [ 6 , 7 ]. Therefore, the presence or absence of pruritus in clinical patients cannot be predicted and explained based on only plasma bilirubin and/or bile acid concentrations.…”

Section: Introductionmentioning

confidence: 99%

Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis

Haijer

Vliet

Brusse-Keizer

et al. 2023

International Journal of Hepatology

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Background and Aim of This Study. Itch frequently occurs in patients with chronic cholestasis. However, it remains unclear why some patients do and others do not develop pruritus. In addition, drug treatment is frequently ineffective. We repeatedly observed that cholestatic patients without itch had a relatively high serum gamma-glutamyl transpeptidase (GGT), relative to their serum bilirubin. The aim of this study was to validate this clinical observation. Methods. We included 235 patients with chronic extrahepatic cholestasis due to pancreatic cancer, cholangiocarcinoma, or papillary carcinoma. Results. GGT was significantly higher in patients without pruritus (median 967, IQR 587–1571) compared to patients with pruritus (median 561 IQR 266–1084 IU/l) ( p < 0.01 ). In contrast, median alkaline phosphatase (AP) was 491 U/L (IQR; 353–684) in patients with pruritus and was not significantly different from 518 U/L (IQR; 353–726) in patients without pruritus ( p = 0.524 ). Direct bilirubin was significantly higher in patients with pruritus compared to patients without pruritus (168 μmol/L (IQR; 95–256) vs. 120 μmol/L (IQR; 56.75–185.5)) ( p < 0.01 ). After correcting for the extent of cholestasis via direct bilirubin, the negative association between GGT and pruritus remained significant and became stronger ( p < 0.001 ). Conclusion. Serum GGT activity is inversely associated with the presence of cholestatic itch in patients with chronic extrahepatic cholestasis.

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“…Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disease that usually occurs in the second or third trimester of pregnancy. Its clinical manifestations are mild to severe persistent pruritus, abnormal liver function, and elevated total bile acid (TBA) levels (Bicocca et al, 2018;Abdelhafez et al, 2022). While maternal risks are minimal with ICP, fetal complications such as premature delivery, meconium-stained amniotic fluid, neonatal depression, respiratory distress, and stillbirth can be significant (Glantz, Marschall and Mattsson, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy: from an obstetrician point of view

Cited by 5 publications

References 68 publications

LC-MS/MS untargeted lipidomics uncovers placenta lipid signatures from intrahepatic cholestasis of pregnancy

LC-MS/MS untargeted lipidomics uncovers placenta lipid signatures from intrahepatic cholestasis of pregnancy

Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis

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