Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China.
Med Hypotheses. 2013 Sep;81(3):374-5. doi: 10.1016/j.mehy.2013.05.018. Epub 2013 Jun 27.
Intrahepatic cholestasis of pregnancy (ICP) is a common complication of pregnancy manifested as skin pruritus of cholestasis. ICP occurs mainly in the second or third trimester of pregnancy and may cause fetal distress, unexpected intrauterine fetal death and does serious harm to maternal and fetal health. The pathogenesis of ICP is still unclear. In ICP placentas, placental syncytiotrophoblasts are the most direct contact between maternal high bile acid environment and fetus. Our previous study found that in ICP placental syncytiotrophoblasts, both mRNA expression level and protein expression level of vascular cell adhesion molecule-1 (VCAM-1), were significantly elevated. Since VCAM-1 is important in inflammatory injury of lymphocytes, we speculate that ICP pathogenesis may be associated with VCAM-1 up-regulation which may lead to inflammatory injury and cause intrauterine fetal distress, intrauterine fetal death and other adverse outcomes. Elucidation of this mechanism should help reveal the ICP pathogenesis and facilitate the clinical treatment of intrauterine fetal death.
妊娠肝内胆汁淤积症（ICP）是一种常见的妊娠并发症，表现为胆汁淤积性皮肤瘙痒。ICP 主要发生在妊娠的第二个或第三个 trimester，可能导致胎儿窘迫、意外宫内胎儿死亡，对母婴健康造成严重危害。ICP 的发病机制尚不清楚。在 ICP 胎盘组织中，胎盘合体滋养层是母体高胆汁酸环境与胎儿最直接的接触部位。我们之前的研究发现，在 ICP 胎盘合体滋养层中，血管细胞黏附分子-1（VCAM-1）的 mRNA 表达水平和蛋白表达水平均显著升高。由于 VCAM-1 在淋巴细胞炎症损伤中起重要作用，我们推测 ICP 的发病机制可能与 VCAM-1 的上调有关，这可能导致炎症损伤，并导致宫内胎儿窘迫、宫内胎儿死亡等不良结局。阐明这一机制有助于揭示 ICP 的发病机制，并有助于宫内胎儿死亡的临床治疗。
