Pregnancy and bile acid disorders

Pataia, Vanessa; Dixon, Peter H.; Williamson, Catherine

doi:10.1152/ajpgi.00028.2017

Cited by 63 publications

(70 citation statements)

References 54 publications

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“…ICP has been associated with multiple gestations and advanced maternal age, and familial clustering of cases of ICP suggests a genetic component. 10 ICP likely results from both environmental and hormonal influences in genetically susceptible women.…”

Section: What Is the Differential Diagnosis Of Pruritus In Pregnancy?mentioning

confidence: 99%

Society for Maternal-Fetal Medicine Consult Series #53: Intrahepatic cholestasis of pregnancy

Lee

Greenberg

Metz

et al. 2021

American Journal of Obstetrics and Gynecology

107

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ACOG) endorses this document.Intrahepatic cholestasis of pregnancy is a hepatic disorder characterized by pruritus and an elevation in serum bile acid levels. Although intrahepatic cholestasis of pregnancy poses little risk for women, this condition carries a significant risk for the fetus, including complications such as preterm delivery, meconium-stained amniotic fluid, and stillbirth. The purpose of this Consult is to review the current literature on intrahepatic cholestasis of pregnancy and provide recommendations based on the available evidence. The recommendations by the Society for Maternal-Fetal Medicine are as follows: (1) we recommend measurement of serum bile acid and liver transaminase levels in patients with suspected intrahepatic cholestasis of pregnancy (GRADE 1B); (2) we recommend that ursodeoxycholic acid be used as the first-line agent for the treatment of maternal symptoms of intrahepatic cholestasis of pregnancy (GRADE 1A); (3) we suggest that patients with a diagnosis of intrahepatic cholestasis of pregnancy begin antenatal fetal surveillance at a gestational age when delivery would be performed in response to abnormal fetal testing results or at the time of diagnosis if the diagnosis is made later in gestation (GRADE 2C); (4) we recommend that patients with total bile acid levels of 100 mmol/L be offered delivery at 36 0/7 weeks of gestation, given that the risk of stillbirth increases substantially around this gestational age (GRADE 1B); (5) we recommend delivery between 36 0/7 and 39 0/7 weeks of gestation for patients with intrahepatic cholestasis of pregnancy and total bile acid levels of <100 mmol/L (GRADE 1C); (6) we recommend administration of antenatal corticosteroids for fetal lung maturity for patients delivering before 37 0/7 weeks of gestation if not previously administered (GRADE 1A); (7) we recommend against preterm delivery at <37 weeks of gestation in patients with a clinical diagnosis of intrahepatic cholestasis of pregnancy without laboratory confirmation of elevated bile acid levels (GRADE 1B).

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Section: What Is the Differential Diagnosis Of Pruritus In Pregnancy?mentioning

confidence: 99%

Society for Maternal-Fetal Medicine Consult Series #53: Intrahepatic cholestasis of pregnancy

Lee

Greenberg

Metz

et al. 2021

American Journal of Obstetrics and Gynecology

107

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“…Pregnancy is commonly associated with extensive physiological and metabolic changes to accommodate the growing needs of fetuses [14]. A typical example is the progressive increase of serum BA during pregnancy, especially in the second and the third trimester [15,16], and a subset of women with serum BA level above reference ranges (≥11 μmol/L) develop intrahepatic cholestasis of pregnancy (ICP) [17].…”

Section: Introductionmentioning

confidence: 99%

Transcriptome Profiling of Placenta through Pregnancy Reveals Dysregulation of Bile Acids Transport and Detoxification Function

Wang

Song

Zhong

et al. 2019

IJMS

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Placenta performs the function of several adult organs for the fetus during intrauterine life. Because of the dramatic physiological and metabolic changes during pregnancy and the strong association between maternal metabolism and placental function, the possibility that variation in gene expression patterns during pregnancy might be linked to fetal health warrants investigation. Here, next-generation RNA sequencing was used to investigate the expression profile, including mRNAs and long non-coding RNAs (lncRNAs) of placentas on day 60 of gestation (G60), day 90 of gestation (G90), and on the farrowing day (L0) in pregnant swine. Bioinformatics analysis of differentially expressed mRNAs and lncRNAs consistently showed dysregulation of bile acids transport and detoxification as pregnancy progress. We found the differentially expressed mRNAs, particularly bile salt export pump (ABCB11), organic anion-transporting polypeptide 1A2 (OATP1A2), carbonic anhydrase II (CA2), Na+-HCO3− cotransporter (NBC1), and hydroxysteroid sulfotransferases (SULT2A1) play an important role in bile acids transport and sulfation in placentas during pregnancy. We also found the potential regulation role of ALDBSSCG0000000220 and XLOC_1301271 on placental SULT2A1. These findings have uncovered a previously unclear function and its genetic basis for bile acids metabolism in developing placentas and have important implications for exploring the potential physiological and pathological pathway to improve fetal outcomes.

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“…Bile salts are key components of bile which are critical for digestion in which they help absorption of fat 22 . Interestingly, serum bile salts have emerged as a general biomarker of liver disease, and are the gold-standard diagnostic method for pregnancy cholangitis 24,25 . In addition, several studies have pointed to bile salts as a general biomarker of interest for early cirrhosis, hepatitis, drug-induced liver injury.…”

Section: Introductionmentioning

confidence: 99%

A synthetic receptor platform enables rapid and portable monitoring of liver dysfunction via engineered bacteria

Chang

Zúñiga

Conejero

et al. 2021

Preprint

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Bacterial biosensors, or bactosensors, are promising field-deployable agents for medical and environmental diagnostics. However, the lack of scalable frameworks to systematically program ligand detection limits their applications. Here we present a synthetic receptor platform, termed EMeRALD (Engineered Modularized Receptors Activated via Ligand-induced Dimerization) which supports the modular assembly of sensing modules onto a high-performance, generic signaling scaffold controlling gene expression in E. coli. We applied EMeRALD to detect bile salts, a biomarker of liver dysfunction, by repurposing sensing modules from enteropathogenic Vibrio species. We improved the sensitivity and lowered the limit-of-detection of the sensing module by directed evolution. We then engineered a colorimetric bactosensor detecting pathological bile salt levels in serum from patients having undergone liver transplant, providing an output detectable by the naked-eye. The EMeRALD technology enables functional exploration of natural sensing modules and rapid engineering of synthetic receptors for diagnostics, environmental monitoring, and control of therapeutic microbes.

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Pregnancy and bile acid disorders

Cited by 63 publications

References 54 publications

Society for Maternal-Fetal Medicine Consult Series #53: Intrahepatic cholestasis of pregnancy

Society for Maternal-Fetal Medicine Consult Series #53: Intrahepatic cholestasis of pregnancy

Transcriptome Profiling of Placenta through Pregnancy Reveals Dysregulation of Bile Acids Transport and Detoxification Function

A synthetic receptor platform enables rapid and portable monitoring of liver dysfunction via engineered bacteria

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