The Effect Of Estrogen On Immune Function In The Pathogenesis Of ICP

Objective:To investigate the effect of estrogen on immune function in the Pathogenesis of ICP.Methods:The samples were obtained from15cases of normal pregnancy placenta(NG) and peripheral serum,30cases of ICP patients including mild group (MG)(n=15) and severe group (SG)(n=15). The level of TNF-a and IL-4from serum were measured by ELISA, the expression and localization of TNF-a and IL-4in placenta were examined by immunohistochemical method. Results:1. The level of TNF-a of of peripheral serum in ICP group (887.68±592.83) compared to NG (256.81±174.98), SG (1195.51±640.21) compared to MG (579.86±339.25), were significantly higher(P<0.05). while the level of IL-4ICP group (195.29±140.66) compared to NG (426.12±232.58), SG (113.17±49.41) compared to MG (277.41±155.22), were significantly lower(P<0.05).2. TNF-a and IL-4were mainly found in the intracytoplasm of trophocyte, and there were no expression in epicyte, nucleolus and mesenchymal. The expression of TNF-a of ICP group (10950.18±7.65) compared to NG (361.25±6.18), SG (16520.08±9.81) compared to MG (5380.27±9.05), were significantly strengthen(P<0.05). while the expression of IL-4of ICP group (4080.39±7.23) compared to NG (14309.16±7.39),SG(152.14±4.08)compared to MG(9194.78±7.23), were significantly lower(P<0.05).3. There were positive correlation between the expression of TNF-α IL-4in placenta and peripheral serum (P<0.001)4. The expression of TNF-a in placenta perfused by different concentrations estrogen:NG(361.25±6.18), KRBG (466.79±7.50),20ugE3perfused group (4914.66±8.48),80ug E3perfused group (13838.43±8254.36), NG compared to KRBG(P>0.05). E3perfused group compared to NG, KRBG(P<0.05). and were step up by the concentration of estrogen(P<0.05). The expression of IL-4in placenta perfused by different concentrations estrogen:NG (10206.57±5.36), KRBG(9859.39+6.10),20ugE3perfused group (7903.46±6.26),80ug E3perfused group (192.14±4.08), NG compared to KRBG(P>0.05). E3perfused group compared to NG, KRBG(P<0.05). and were step down by the concentration of estrogen(P<0.05). The expression of TNF-a, IL-4of20ug E3perfused group and MG,80ug E3perfused group and SG were no significant change(P>0.05), while20ug E3perfused group and SG,80ug E3perfused group and MG have significant change(P<0.001). Conclusion:(1) With the ICP sicker, the level of TNF-a of ICP group peripheral serum and placental were higher gradually, while IL-4were lower gradually, there were positive correlation between the expression of TNF-α, IL-4in placenta and peripheral serum, illustrate that placenta immune function may play an important role in ICP pathogenesis.(2) High concentration estrogen may lead to the expression of TNF-a were increased after perfused, while IL-4were delined, and changed with the higher the concentration of estrogen. Low and high concentration estrogen perfusion placenta lobules could lead to change of immune function which is similar with MG and SG. Pointed that high concentration estrogen may lead to immune dysfunction, and this may be one of the pathogenesis in ICP.