Immunologic abnormality of intrahepatic cholestasis of pregnancy.
OBJECTIVE
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy risk because of the possibility of pre-term delivery and sudden intrauterine fetal death. Its pathogenesis is still under discussion.


METHODS
The analysis of the recent findings on the complex immunologic events that occur in ICP were performed.


RESULTS
In ICP, an increase of type 1 cytokine (TNF-alpha, IFN-gamma) associated with a decrease of type 2 cytokine (IL-4). The decreased production of the suppressor cytokine TGF-beta2 may increase the type 1 cytokine. Fas appeared to be increased and FasL appeared to be decreased in syncytiotrophoblasts of ICP. The human leukocyte antigen gene (HLA-G, E) in extravillous trophoblasts of ICP were significantly decreased.


CONCLUSIONS
Th1/Th2 cytokine balance and HLA play important roles in the tolerance and maintenance of pregnancy. ICP may be resulting from breach of the maternal fetal immune tolerance during pregnancy.
Yayi
Hu
H
Department of Obstetrics and Gynecology, The Second West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Danqing
Wang
W
Shuyun
Liu
L
Jicheng
Liu
L
D000818:Animals; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000235:genetics / Q000276:immunology*; D016207:Cytokines / Q000276:immunology; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics / Q000276:immunology* / Q000473:pathology
D016207:Cytokines; D006680:HLA Antigens