Profile of bile acids in fetal gallbladder and meconium using liquid chromatography-tandem mass spectrometry

Naritaka, Nakayuki; Suzuki, Mitsuyoshi; Sato, Hiroaki; Takei, Hiroyuki; Murai, Tsuyoshi; Kurosawa, Takao; Iida, Takashi; Nittono, Hiroshi; Shimizu, Toshiaki

doi:10.1016/j.cca.2015.04.008

Cited by 28 publications

(16 citation statements)

References 22 publications

(26 reference statements)

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“…A recent study analyzing bile acid species in the biliary tract and in the intestinal meconium of infants who died from miscarriage or soon after birth reported the presence of sulfate-conjugated bile acids in the meconium but not in gallbladder bile, which suggests that their origin probably is mainly the amniotic fluid swallowed by the fetuses [39]. Bile acid concentrations in amniotic fluid are 70-fold higher in ICP pregnancies than in controls [40], and are also significantly higher in the meconium of newborns from women with ICP than in controls [41].…”

Section: Discussionmentioning

confidence: 99%

Relationship between early onset severe intrahepatic cholestasis of pregnancy and higher risk of meconium-stained fluid

et al. 2017

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BackgroundIntrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disease. The risk of adverse fetal outcome has been associated with the severity of maternal hypercholanemia after diagnosis.ObjectiveTo investigate whether there is a relationship between the severity and timing of onset of hypercholanemia and the risk of meconium-stained amniotic fluid (MSAF) and adverse neonatal events.Study designThe study included 382 pregnancies complicated by ICP managed at a referral hospital in Buenos Aires (Argentina) between June 2009 and December 2013. The patients were classified into three groups according to the severity of hypercholanemia at diagnosis; mild (10–19.9 μmol/L), moderate (20–39.9 μmol/L) and severe (≥40 μmol/L). Their clinical characteristics and pregnancy outcomes were investigated in a prospective observational study.ResultsHigher risk of MSAF was observed when ICP appeared early in gestation or when hypercholanemia was more severe. Taking both parameters into account an MSAF risk factor (MRF) was defined. Based on a model of positive/negative predictive values, a cut-off point of MRF = 3 was selected, which prioritized sensitivity versus specificity. In ICP patients with MRF>3, the probability of MSAF was enhanced 4-fold. An increase in the frequency of MSAF was also associated with higher serum levels at diagnosis of alanine transaminase, alkaline phosphatase and direct bilirubin.ConclusionsThe risk of MSAF is associated not only with the magnitude of hypercholanemia at diagnosis but also with the early gestational onset of raised maternal serum bile acids.

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Section: Discussionmentioning

confidence: 99%

Relationship between early onset severe intrahepatic cholestasis of pregnancy and higher risk of meconium-stained fluid

et al. 2017

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“…The values of LODs observed with meconium matrices were higher than those detected with solvent and LC‐MS. This was mainly ascribed to the ion suppression caused by complex matrices in this kind of ambient direct ESI with solid substrate because meconiums contain digestive juice, intestinal epithelial cells, hair, bile, swallowed amniotic fluid water and other metabolites . The interfering compounds from the matrix may make it difficult to be detected at lower concentrations.…”

Section: Resultsmentioning

confidence: 99%

“…Meconium is formed during 12th–13th weeks of gestation in intestinal compartments and is accumulated until birth. Meconium has been widely used to evaluate the tobacco exposure of a foetus during pregnancy in polluted environments . Unlike other fetal matrices (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Medical swab touch spray‐mass spectrometry for newborn screening of nicotine and cotinine in meconium

et al. 2016

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Newborn screening is one of public health concerns designed to screen infants shortly after birth. Prenatal exposure to tobacco smoke such as nicotine has been reported to affect babies. Levels of nicotine and cotinine in meconium were widely used to evaluate the tobacco exposure of foetuses during pregnancy in a polluted environment. In this study, medical swabs were applied by using touch spray-mass spectrometry (TS-MS) to collect meconium from newborn infants for detection of nicotine and cotinine. Parameters such as choice of spray solvents, solvent volume and collision energy for screening of nicotine and cotinine were optimized. The limits of detection, reproducibility and matrix effect for analysis of meconium were also investigated. In this study, the levels of nicotine and cotinine in 54 puerpera volunteers were screened by TS-MS and were validated by using traditional liquid chromatography-mass spectrometry. These results showed that medical swab TS-MS would be useful for newborn screening of nicotine and cotinine in meconium with high reproducibility, speed, sensitivity and specificity. The use of disposable medical swabs involves no sample preparation and no chromatographic separation, significantly reducing the cost and time required for screening a large number of clinical sample. Copyright © 2016 John Wiley & Sons, Ltd.

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“…Profiles (collected postmortem) of fetal gallbladder bile are similar to those in the intestine with the exception of sulfate conjugates and the proportion of deoxycholic acid (DCA). Thus, one study noted that DCA was notably absent from the bile of infants and some children, and this may suggest that the dehydroxylation of CA by colonic bacteria may have contributed to the absence of DCA in the gallbladder bile; however, this was based on bile from gallbladders obtained postmortem from 30 human subjects rather than from otherwise healthy subjects.…”

Section: Literature Supporting the Hypothesis Of Bile Acid Immaturitymentioning

confidence: 93%

Exploring hypotheses and rationale for causes of infantile colic

Camilleri

Park

Scarpato

et al. 2016

Neurogastroenterology Motil

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Background Infantile colic is a frequent problem in neonates and infants. This review addresses current management including the results for nutrient modifications, soy-based formulas, and prebiotics, probiotics and synbiotics. Purpose Given the evidence that there is still an unmet clinical need, as current treatments are incompletely efficacious, we have examined the evidence around three hypothetical mechanisms that could potentially be involved in etiopathogenesis of infantile colic: immaturity of bile acid mechanisms that alter intraluminal and absorptive mechanisms, immaturity in motility and alterations in the microbiome. Understanding these potential mechanisms may lead to the introduction of diagnostic procedures that should enhance the selection or individualization of therapy for infantile colic.

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Profile of bile acids in fetal gallbladder and meconium using liquid chromatography-tandem mass spectrometry

Cited by 28 publications

References 22 publications

Relationship between early onset severe intrahepatic cholestasis of pregnancy and higher risk of meconium-stained fluid

Relationship between early onset severe intrahepatic cholestasis of pregnancy and higher risk of meconium-stained fluid

Medical swab touch spray‐mass spectrometry for newborn screening of nicotine and cotinine in meconium

Exploring hypotheses and rationale for causes of infantile colic

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