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Molecular pathogenesis of intrahepatic cholestasis of pregnancy

Published online by Cambridge University Press:  28 March 2008

Marco Arrese*
Affiliation:
Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rocio I.R. Macias
Affiliation:
Laboratory of Experimental Hepatology and Drug Targeting (HEVEFARM)
Oscar Briz
Affiliation:
Research Unit, CIBERehd, University Hospital, University of Salamanca, Spain.
Maria J. Perez
Affiliation:
Research Unit, CIBERehd, University Hospital, University of Salamanca, Spain.
Jose J.G. Marin
Affiliation:
Laboratory of Experimental Hepatology and Drug Targeting (HEVEFARM)
*
*Corresponding author: Marco Arrese, Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 833-0024, Chile. Tel:  + 56 2 6863820; Fax:  + 56 2 6397780; E-mail: marrese@med.puc.cl

Abstract

Intrahepatic cholestasis of pregnancy (ICP) occurs mainly in the third trimester and is characterised by pruritus and elevated serum bile acid levels. ICP is associated with an increased perinatal risk and higher rates of foetal morbidity and mortality. Although the pathogenesis of this disease is unknown, a genetic hypersensitivity to female hormones (oestrogen and/or progesterone) or their metabolites is thought to impair bile secretory function. Recent data suggest that mutations or polymorphisms of genes expressing hepatobiliary transport proteins or their nuclear regulators may contribute to the development and/or severity of ICP. Unidentified environmental factors may also influence pathogenesis of the disease. This review summarises current knowledge on the potential mechanisms involved in ICP at the molecular level.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2008

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References

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Further reading, resources and contacts

The website from The Cholestatic Liver Disease Consortium CLiC, is a collaborative efforyt of a team of doctors, nurses, research coordinators and patient support organisations throughout the USA and UK, working together to improve the lives of children and families dealing with rare Cholestatic Liver Diseases. This website provides background on the significance of transporter mutations.

Balistreri, W.F. et al. (2005) Intrahepatic cholestasis: summary of an American Association for the Study of Liver Diseases single-topic conference. Hepatology 42, 222-235Google Scholar
Geier, A. et al. (2007) Principles of hepatic organic anion transporter regulation during cholestasis, inflammation and liver regeneration. Biochim Biophys Acta 1773, 283-308Google Scholar
Balistreri, W.F. et al. (2005) Intrahepatic cholestasis: summary of an American Association for the Study of Liver Diseases single-topic conference. Hepatology 42, 222-235Google Scholar
Geier, A. et al. (2007) Principles of hepatic organic anion transporter regulation during cholestasis, inflammation and liver regeneration. Biochim Biophys Acta 1773, 283-308Google Scholar