title: Immunological basis in the pathogenesis of intrahepatic cholestasis of pregnancy.
abstract: Intrahepatic cholestasis of pregnancy poses a great risk to both maternal and fetal health. Despite extensive research, much of the pathogenesis of this disorder is unknown. The increase in bile acids observed in patients with intrahepatic cholestasis of pregnancy has been noted to cause a change in the immune system from the normally mediated TH2 response to one that is more oriented towards TH1. In this literature review, we have critically reviewed the current literature regarding the changes in the immune system and the potential effects of immunological changes in the management of the patient. The current treatment, ursodeoxycholic acid, is also discussed along with potential combination therapies and future directions for research.
authors.affiliation: a Center for Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA.|b Department of Obstetrics and Gynecology , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Spencer P
authors.initials: SP
authors.lastname: Larson
authors.affiliation: b Department of Obstetrics and Gynecology , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Oormila
authors.initials: O
authors.lastname: Kovilam
authors.affiliation: a Center for Clinical & Translational Science , Creighton University School of Medicine , Omaha , NE , USA.
authors.forename: Devendra K
authors.initials: DK
authors.lastname: Agrawal
mesh_terms: D000818:Animals; D002779:Cholestasis / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D006801:Humans; D007109:Immunity; D008099:Liver / Q000276:immunology / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000276:immunology*; D058408:Th1-Th2 Balance; D018418:Th2 Cells / Q000276:immunology*; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D014580:Ursodeoxycholic Acid
keywords: S-adenosylmethionine; T-lymphocytes; bile acids; intrahepatic cholestasis of pregnancy; ursodeoxycholic acid