title: TPN cholestasis in infants: what do we know? Review.
abstract: Cholestasis is a condition in which there is a decrease in or complete cessation of bile flow. Total Parenteral Nutrition (TPN) Cholestasis cases have been on the rise due to the decrease ratio of mortality among premature babies. Using Pubmed, articles were searched using terms in combination: Molecular basis of cholestasis and management. The literature was also retrieved from books attributed to experts in the topic. This article describes the definition, incidence, risk factors, pathogenesis,the molecular basis of hepatobiliary transport, bile acid transporters,cellular regulation, and uptodate and prospective medical Care of TPN Cholestasis. It was found that TPN cholestasis in infants is considered as a major epidemic. Targeting Constitutive androstane receptor and Pregnane X receptor potent agonist will be one of the ultimate goals in inventing new pharmacological agents for the management and treatment of cholestasis related to TPN use. Glutamine, Omega 3 and soybean oil fat appear to have a protective role in the development of TPN cholestasis. However, further studies especially randomized control trials should be conducted.
authors.affiliation: Hamad Medical Corporation, Department of Pediatrics, Doha, Qatar.
authors.forename: M
authors.initials: M
authors.lastname: Hendaus
mesh_terms: D001646:Bile / Q000378:metabolism / Q000502:physiology; D001692:Biological Transport; D002779:Cholestasis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D000090702:Constitutive Androstane Receptor; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology; D005973:Glutamine / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000187:drug effects / Q000473:pathology; D058990:Molecular Targeted Therapy; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D000077297:Pregnane X Receptor; D018160:Receptors, Cytoplasmic and Nuclear / Q000378:metabolism; D011987:Receptors, Steroid / Q000378:metabolism; D012307:Risk Factors; D013024:Soybean Oil / Q000494:pharmacology
chemical_list: D000090702:Constitutive Androstane Receptor; D015525:Fatty Acids, Omega-3; D000077297:Pregnane X Receptor; D018160:Receptors, Cytoplasmic and Nuclear; D011987:Receptors, Steroid; D005973:Glutamine; D013024:Soybean Oil