Placental Expression of Farnesoid X Receptor and Its Role in Intrahepatic Cholestasis of Pregnacy / 实用妇产科杂志

ABSTRACT

Objective:To explore the placental expression of farnesoid X receptor( FXR) ,as well as the total bile acid (TBA) levels in maternal and umbilical cord serum in intrahepatic cholestasis of pregnancy (ICP) and normal late pregnancy. To evaluate the roles of placental FXR in the pathological mechanism of ICP. Methods:Maternal and umbilical cord blood as well as placentas were collected in gravidas of 33 ICP (ICP group) and 33 normal late pregnancy (control group). According to maternal serum TBA levels, ICP group was divided into mild and severe subgroup, the latter with TBA ≥40 μmol/L TBA levels were measured by velocimetry and the placental FXR mRNA expression were examined by real time nested RT-PCR. Results:①Comparing the rate of meconium -stain of amniotic fluid The rate in ICP group was significantly higher than that in control group(χ~2=7.543,P=0.013); The rate in serve ICP group was significantly higher than that in mild ICP group(χ~2= 7.637,P=0.013). ②The expression of FXR mRNA in placentas placental FXR mRNA expression was significantly higher in ICP group than that in control group (z = -2. 391, P = 0.017). Placental FXR mRNA expression was higher in severe ICP group than that in mild ICP group (z= -2.391 ,P=0.017).③ln ICP group, a positive correlation was found between the placental FXR mRNA expression and the maternal serum TBA levels as well as umbilical serum TBA levels(r_s =0.348,P=0.047; r_s =0.284,P=0.027). There were no significant correlations between maternal serum as well as umbilical serum TBA levels and placental FXR mRNA expression in control group ( r_s = - 0.068, P = 0.716; r_s = 0.010,P=0.959). Conclusions:Placental FXR mRNA expression is up regulated by increased bile acid levels in ICP, which may represent a compensatory (anti-cholestatic) mechanism of placenta in ICP.