Study On The Relationship Between The Expression Of Placental FXR,BSEP And Intrahepatic Cholestasis Of Pregnacy

Objective:To explore the expression of placental FXR,BSEP,as well as maternal and umbilical cord serum glycocholic acicd(CG) levels.To evaluate the pathogenesis of intrahepatic cholestasis of pregnancy(ICP).Methods:CG levels in 35 cases of ICP and 40 cases of normal pregnancy as compared group were detected in maternal and umbilical cord serum by radioimmunoassay and hepatic function,such as alkaline phosphatase(ALP),aspartate aminotransferase(AST),total bile acid(TBA),was also detected.The express of FXR and BSEP in placenta were detected in both guoups by SP of immunohistochemistry.Results:(1)Maternal and umbilical cord serum CG levels in ICP group were all significantly higher than the control group ( 18507.14±6614.01ng/ml VS 1411.75±406.89ng/ml),(6899.14±1823.05ng/ml VS 2341.50±633.62ng/ml)(P<0.01). The CG level of maternal serum was higher than those of umbilical cord serum, and there was a positive correlation in CG level between in maternal and umbilical cord serum in ICP group(r=0.84). (2)The ALT,AST,ALP,TBA et al level of maternal serum in ICP group were all higher than those of maternal serum in control group. There was a positive correlation in ALP level and maternal serum CG level in ICP group(r=0.68). (3)The expression of FXR and BSEP were all founded in both groups,and the expression of FXR was more in ICP group than control group(16.54±2.16% VS 11.38±1.44 %)(P<0.01),on the contrary ,the BSEP level was lower in ICP group than control group ( 4.94±1.11% VS 7.53±1.04% ) (P<0.01).(4)There was a positive correlation in expression of FXR and CG level of maternal and umbilical cord serum in ICP group(r=0.58,0.54).However,between the expression of BSEP and the CG level of maternal and umbilical cord serum,there was a negative correlation in ICP group(r=-0.42,-0.30).Conclusion: The CG level in maternal and umbilical cord serum in ICP group was significantly higher than that of control group. The expression of FXR was more in ICP group than control group. Then, the expression of BSEP on placenta falls in patients with ICP. The dysfunction of placenta transport bile acid resulted in fetal cholestasis,this may be one of the mechanisms of ICP.