Document Detail

High viral load and deregulation of the progesterone receptor signaling pathway: association with hepatitis E-related poor pregnancy outcome.
MedLine Citation:
PMID:  21145845     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Hepatitis E virus (HEV) infection is associated with high maternal and fetal mortalities. A prospective study was undertaken to evaluate the role of viral and host factors in HEV related pregnancy outcomes.
METHODS: The study included HEV infected pregnancy cases; acute viral hepatitis (AVH), n=100 and fulminant hepatic failure (FHF), n=43, and healthy pregnancy cases, n=50. HEV genotypes and viremia were studied by nucleotide sequencing and real time PCR, respectively. Progesterone receptor (PR) gene mutations (PROGINS) were studied by PCR, PR expression at the mRNA and protein levels in the placenta were studied by semi-quantitative RT-PCR and immunohistochemistry, respectively. Progesterone induced blocking factor (PIBF) expression was studied by RT-PCR in blood. Serum interleukin-10 (IL-10) and interleukin-12 (IL-12) levels were assayed by ELISA.
RESULTS: HEV viral load was significantly higher in FHF than AVH (p<0.001) and in cases with fetal mortality in AVH (p=0.001) and FHF (p=0.018). PROGINS were predominant in FHF compared to AVH (p=0.26) and showed reduced mRNA and protein expression. The risk of fetal mortality in AVH was two times higher (OR, 2.190; CI, 0.303-15.85) and maternal and fetal mortalities in FHF were 4-fold (OR, 4.0; CI, 0.363-44.113) increased in PROGINS carriers. PR and PIBF expression was lower in AVH and even lower in FHF compared to healthy controls. The higher IL-12/IL-10 ratio observed in FHF compared to other groups correlated with fetal mortality in AVH and FHF (p<0.001).
CONCLUSIONS: In conclusion, reduced expression of PR and PIBF, a higher IL-12/IL-10 ratio, and a high viral load results in poor pregnancy outcome in Hepatitis E.
Purabi Deka Bose; Bhudev C Das; Ashok Kumar; Ranjana Gondal; Deepak Kumar; Premashish Kar
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Publication Detail:
Type:  Journal Article     Date:  2010-11-13
Journal Detail:
Title:  Journal of hepatology     Volume:  54     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-20     Completed Date:  2011-09-27     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1107-13     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Department of Medicine, LNJP Hospital, MAMC, New Delhi, India.
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MeSH Terms
Case-Control Studies
Hepatitis E / complications*,  genetics,  metabolism,  virology
Infant, Newborn
Interleukin-10 / metabolism
Interleukin-12 / metabolism
Liver Failure, Acute / complications,  genetics,  metabolism,  virology
Models, Biological
Pregnancy Complications, Infectious / genetics*,  metabolism,  virology*
Pregnancy Outcome
Pregnancy Proteins / genetics
Prospective Studies
RNA, Messenger / genetics,  metabolism
Receptors, Progesterone / genetics*
Signal Transduction / genetics
Suppressor Factors, Immunologic / genetics
Th1 Cells / immunology
Th2 Cells / immunology
Viral Load
Young Adult
Reg. No./Substance:
0/IL10 protein, human; 0/PIBF1 protein, human; 0/Pregnancy Proteins; 0/RNA, Messenger; 0/Receptors, Progesterone; 0/Suppressor Factors, Immunologic; 130068-27-8/Interleukin-10; 187348-17-0/Interleukin-12

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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