Tribe, Rachel M., Dann, Anthony T., Kenyon, Anna P., Seed, Paul, Shennan, Andrew H. and Mallet, Anthony (2010) Longitudinal profiles of 15 serum bile acids in patients with intrahepatic cholestasis of pregnancy. The American Journal of Gastroenterology, 105. pp. 585-595. ISSN 0002-9270 (Print), 1572-0241 (Online) (doi:10.1038/ajg.2009.633)

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Abstract

OBJECTIVES: Increased maternal serum bile acids are implicated in intrahepatic cholestasis of pregnancy. Individual bile acid profiles and their relationship with disease progression, however, remain unknown. The purpose of this prospective study was to determine the temporal changes in bile acids in normal pregnancy and in pregnancies complicated with intrahepatic cholestasis of pregnancy and pruritus gravidarum. METHODS: A validated method for the evaluation of 15 bile acids (conjugated and unconjugated) in a single serum sample was developed using high-performance liquid chromatography/mass spectrometry (HPLC-MS) with an electrospray interface. Bile acid concentrations were assessed in samples (16 weeks of gestation to 4 weeks postpartum) from women with, or who later developed, intrahepatic cholestasis of pregnancy (n=63) and were compared with those from normal pregnant women (n=26) and from women with pruritus gravidarum (n=43). RESULTS: Intrahepatic cholestasis of pregnancy was associated with a predominant increase in cholic acid conjugated with taurine and glycine, from 24 weeks of pregnancy. Ursodeoxycholic acid (UDCA) treatment (≥21 days, n=15) significantly reduced serum taurocholic and taurodeoxycholic acid concentrations (P<0.01). Bile acid profiles were similar in normal pregnancy and pregnancy associated with pruritus gravidarum. CONCLUSIONS: The bile acid profiles and effects of treatment by UDCA implicate a role for taurine-conjugated bile acids in the syndrome of intracranial pressure. With regard to individual bile acid profiles, pruritus gravidarum is a disorder quite distinct from intrahepatic cholestasis of pregnancy.

Item Type:	Article
Additional Information:	[1] Journal Edition named 'Liver and Biliary Tract'
Uncontrolled Keywords:	maternal serum bile acids, intrahepatic cholestasis, pruritus gravidarum, high-performance liquid chromatography/mass spectrometry (HPLC-MS), ursodeoxycholic acid (UDCA)
Subjects:	R Medicine > R Medicine (General) R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group:	Faculty of Engineering & Science
Related URLs:	Publisher
Last Modified:	14 Oct 2016 09:19
URI:	http://gala.gre.ac.uk/id/eprint/7774

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