The Change Of Immunal Modulation On The Placenta Of Intrahepatic Cholestasis Of Pregnancy

Objective: To investigate the effect of T helper cell type-1 (Th1) cytokines (tumor necrosis factor-a, TNF-a, interferon-r, IFN-r), T helper cell type-2 (Th2) cytokines (interleukin-6, 10,IL-6, 10) and cell apoptosis on immune pathogenesis of intrahepatic cholestasis of pregnancy (ICP) in placenta. The causes of higher rate on premature fetal death, stillborn and neonatal death with ICP was explored and the theoretic basis for treatment in ICP was provided. Methods: 36 cases of ICP patients and 31 cases of normal pregnant women in our hospital were recruited from Feb,1999 to June, 2003. All of them were taken ceserean section before the onset of labor. The immunohistochemistryN In situ hybridization and TUNEL ( TdT-mediated dUTP nick end labeling) methods were used to detect the expression of TNF-a, IFN-r, IL-6, IL-10 and apoptosis index. Results: The expression of TNF-a in ICP group was higher than that in control group (P<0.05). The expression of IFN-r,IL-6, IL-10 in ICP group was not significantly higher (P>0.05). The apoptosis index in placental syncytotrophoblast, decidual cells and mediate cells in ICP group was significantly higher than that in control group (P<0.05). Conclusion: There was an imbalance of Thl and Th2 in the placenta. With the enhancement of Thl cells' function, they will damage the function of placenta through apoptosis, and result in the harmful outcome of ICP.