2017, Number 2
<< Back Next >>
Ann Hepatol 2017; 16 (2)
Identification of Matrix Metalloproteinase-2 and 9 as Biomarker of Intrahepatic Cholestasis of Pregnancy
Chen Z, Shen Z, Hu L, Lu M, Feng Y
Language: English
References: 33
Page: 291-296
PDF size: 210.70 Kb.
ABSTRACT
Intrahepatic cholestasis of pregnancy (ICP) is a severe liver disease uniquely occurring during pregnancy. In this study we aimed to
identify novel biomarker for the diagnosis of ICP in Chinese population. 50 healthy pregnant women, 50 mild ICP patients and 48 severe
ICP patients were enrolled for this study. Liver function tests, including serum total bilirubin, direct bilirubin, alanine transaminase,
aspartate aminotransferase and cholyglycine, were performed in all participants. After an overnight fast serum levels of total
bile acids (TBA), matrix metalloproteinase (
MMP)
-2 and
MMP-9 were measured, and their correlation with liver function tests were
analyzed. The observed increase in serum TBA in ICP patients was not statistically significant which made it unreliable for diagnosis
of ICP in Chinese population. On the other hand, both
MMP-2 and
MMP-9 serum levels exhibited a progressive and significant elevation
in mild and severe ICP patients compared with healthy pregnant women, which also positively correlated with liver function
tests. Serum levels of both
MMP-2 and
MMP-9 could be reliably used as laboratory abnormalities for accurate diagnosis and sensitive
grading of ICP in Chinese population.
REFERENCES
Geenes V, Williamson C. Intrahepatic cholestasis of pregnancy. World J Gastroenterol 2009: 15: 2049-66.
Reyes H. Review: intrahepatic cholestasis. A puzzling disorder of pregnancy. J Gastroenterol Hepatol 1997: 12: 211- 6.
Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology 2004: 40: 467-74. doi: 10.1002/hep.20336.
Nichols AA. Cholestasis of pregnancy: a review of the evidence. J Perinat Neonatal Nurs 2005: 19: 217-25.
Reyes H, Radrigan ME, Gonzalez MC, Latorre R, Ribalta J, Segovia N, Alvarez C, et al. Steatorrhea in patients with intrahepatic cholestasis of pregnancy. Gastroenterology 1987: 93: 584-90.
Mullally BA, Hansen WF. Intrahepatic cholestasis of pregnancy: review of the literature. Obstet Gynecol Surv 2002: 57: 47-52.
Pusl T, Beuers U. Intrahepatic cholestasis of pregnancy. Orphanet J Rare Dis 2007: 2: 26. doi: 10.1186/1750-1172-2- 26.
Riely CA, Bacq Y. Intrahepatic cholestasis of pregnancy. Clin Liver Dis 2004:8:167-76. doi: 10.1016/S1089- 3261(03)00131-4.
Lee RH, Goodwin TM, Greenspoon J, Incerpi M. The prevalence of intrahepatic cholestasis of pregnancy in a primarily Latina Los Angeles population. J Perinatol 2006: 26: 527-32. doi: 10.1038/sj.jp.7211545.
Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000: 33: 1012-21.
Reyes H. Sex hormones and bile acids in intrahepatic cholestasis of pregnancy. Hepatology 2008: 47: 376-9. doi: 10.1002/hep.22139.
Abedin P, Weaver JB, Egginton E. Intrahepatic cholestasis of pregnancy: prevalence and ethnic distribution. Ethn Health 1999: 4: 35-7. doi: 10.1080/13557859998173.
Beuers U, Pusl T. Intrahepatic cholestasis of pregnancy—a heterogeneous group of pregnancy-related disorders? Hepatology 2006: 43: 647-9. doi: 10.1002/hep.21156.
Zhang L, Zhang F, Tang L, Yang W, Zhang X. Intrahepatic cholestasis of pregnancy and fetal injury. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2013: 38: 645-52. doi: 10.3969/ j.issn.1672-7347.2013.06.015.
Li L, Zhao XY, Ou XJ, Jia JD. Clinical analysis of intrahepatic cholestasis of pregnancy. Zhonghua Gan Zang Bing Za Zhi 2013: 21: 295-8. doi: 10.3760/cma.j.issn.1007- 3418.2013.04.013.
Pathak B, Sheibani L, Lee RH. Cholestasis of pregnancy. Obstet Gynecol Clin North Am 2010:37:269-82. doi: 10.1016/j.ogc.2010.02.011.
Heikkinen J, Maentausta O, Tuimala R, Ylostalo P, Janne O. Amniotic fluid bile acids in normal and pathologic pregnancy. Obstet Gynecol 1980: 56: 60-4.
Laatikainen T, Tulenheimo A. Maternal serum bile acid levels and fetal distress in cholestasis of pregnancy. Int J Gynaecol Obstet 1984: 22: 91-4.
Rodrigues CM, Marin JJ, Brites D. Bile acid patterns in meconium are influenced by cholestasis of pregnancy and not altered by ursodeoxycholic acid treatment. Gut 1999: 45: 446-52.
Meng LJ, Reyes H, Axelson M, Palma J, Hernandez I, Ribalta J, Sjövall J, et al. Progesterone metabolites and bile acids in serum of patients with intrahepatic cholestasis of pregnancy: effect of ursodeoxycholic acid therapy. Hepatology 1997: 26: 1573-9. doi: 10.1002/hep.510260627.
Brites D, Rodrigues CM, van-Zeller H, Brito A, Silva R. Relevance of serum bile acid profile in the diagnosis of intrahepatic cholestasis of pregnancy in an high incidence area: Portugal. Eur J Obstet Gynecol Reprod Biol 1998: 80: 31-8.
Mays JK. The active management of intrahepatic cholestasis of pregnancy. Curr Opin Obstet Gynecol 2010: 22: 100-3. doi: 10.1097/GCO.0b013e328337238d.
Huang WM, Gowda M, Donnelly JG. Bile acid ratio in diagnosis of intrahepatic cholestasis of pregnancy. Am J Perinatol 2009: 26: 291-4. doi: 10.1055/s-0028-1103158.
Qi HB, Shao Y, Wu WX, Zhang JH. Grading of intrahepatic cholestasis of pregnancy. Zhonghua Fu Chan Ke Za Zhi 2004: 39: 14-7.1
Mashige F, Imai K, Osuga T. A simple and sensitive assay of total serum bile acids. Clin Chim Acta 1976: 70: 79-86.
Feldmann D, Fenech C, Cuer JF. Evaluation of a samplepreparation procedure for bile acids in serum and bile. Clin Chem 1983: 29: 1694.
Koucký M, Germanová A, Kalousová M, Hill M, Cindrová-Davies T, Parízek A, Svarcová J, et al. Low maternal serum matrix metalloproteinase (MMP)-2 concentrations are associated with preterm labor and fetal inflammatory response. J Perinat Med 2010: 38: 589-96. doi: 10.1515/ JPM.2010.092.
Forster O, Hilfiker-Kleiner D, Ansari AA, Sundstrom JB, Libhaber E, Tshani W, Becker A, et al. Reversal of IFN-gamma, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy. Eur J Heart Fail 2008:10:861-8. doi: 10.1016/j.ejheart.2008.07.005.
Stojanovic N, Lewandowski K, Salata I, Bienkiewicz M, Tuck S, Prelevic G, Press M., et al. Serum levels of matrix metalloproteinases MMP-2 and MMP-9 and their inhibitors in women with glucose intolerance in pregnancy and normal controls. Gynecol Endocrinol 2010:26:201-7. doi: 10.1080/ 09513590902972026.
Montagnana M, Lippi G, Albiero A, Scevarolli S, Salvagno GL, Franchi M, Guidi GC, et al. Evaluation of metalloproteinases 2 and 9 and their inhibitors in physiologic and pre-eclamptic pregnancy. J Clin Lab Anal 2009:23:88-92. doi: 10.1002/jcla.20295.
Wang Z, Lu S, Liu C, Zhao B, Pei K, Tian L, Ma X, et al. Expressional and epigenetic alterations of placental matrix metalloproteinase 9 in preeclampsia. Gynecol Endocrinol 2010: 26: 96-102. doi: 10.3109/09513590903184100.
Merchant SJ, Crocker IP, Baker PN, Tansinda D, Davidge ST, Guilbert LJ. Matrix metalloproteinase release from placental explants of pregnancies complicated by intrauterine growth restriction. J Soc Gynecol Investig 2004: 11: 97-103. doi: 10.1016/j.jsgi.2003.08.005.
Fortunato SJ, Menon R, Lombardi SJ. Amniochorion gelatinase- gelatinase inhibitor imbalance in vitro: a possible infectious pathway to rupture. Obstet Gynecol 2000: 95: 240-4.