Document Detail


Longitudinal profiles of 15 serum bile acids in patients with intrahepatic cholestasis of pregnancy.
MedLine Citation:
PMID:  19904249     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (> or =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 intrahepatic cholestasis of pregnancy. [corrected] With regard to individual bile acid profiles, pruritus gravidarum is a disorder quite distinct from intrahepatic cholestasis of pregnancy.
Authors:
Rachel M Tribe; Anthony T Dann; Anna P Kenyon; Paul Seed; Andrew H Shennan; Anthony Mallet
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-11-10
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-04-15     Revised Date:  2010-09-13    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  585-95     Citation Subset:  IM    
Affiliation:
Division of Reproduction and Endocrinology, King's College London, London, UK. rachel.tribe@kcl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Bile Acids and Salts / blood*
Cholestasis, Intrahepatic / blood*,  physiopathology
Chromatography / methods
Disease Progression
Female
Humans
Liver Function Tests
London
Pregnancy
Pregnancy Complications / blood*,  physiopathology
Prospective Studies
Pruritus / blood*,  physiopathology
Regression Analysis
Time Factors
Chemical
Reg. No./Substance:
0/Bile Acids and Salts
Comments/Corrections
Comment In:
Am J Gastroenterol. 2010 Mar;105(3):596-8   [PMID:  20203641 ]
Erratum In:
Am J Gastroenterol. 2010 Sep;105(9):2123

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


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