Immunology of hepatic diseases during pregnancy.
The mother's immune system has to adapt to pregnancy accepting the semi-allograft fetus and preventing harmful effects to the developing child. Aberrations in feto-maternal immune adaptation may result in disease of the mother, such as liver injury. Five pregnancy-associated liver disorders have been described so far, however, little is known concerning immune alterations promoting the respective disease. These liver disorders are pre-eclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP), acute fatty liver, hyperemesis gravidarum, and intrahepatic cholestasis of pregnancy. On the other hand, pre-existing autoimmune liver injury of the mother can be affected by pregnancy. This review intends to summarize current knowledge linking feto-maternal immunology and liver inflammation with a special emphasis on novel potential biomarkers.
Institute of Experimental Immunology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Lars
L
Bremer
I. Department of Medicine and Martin Zeitz Centre for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Christoph
C
Schramm
Institute of Experimental Immunology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. g.tiegs@uke.de.|Institut für Experimentelle Immunologie und Hepatologie, Universitätsklinikum Hamburg Eppendorf, Martinistrasse 52, N27, 20246, Hamburg, Germany. g.tiegs@uke.de.
Gisa
G
Tiegs
D015415:Biomarkers; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007108:Immune Tolerance; D007109:Immunity; D007114:Immunization; D015994:Incidence; D008099:Liver / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications; D011379:Prognosis
D015415:Biomarkers
Acute fatty liver of pregnancy; Auto immune hepatitis; HELLP; Hyperemesis gravidarum; Intrahepatic cholestasis of pregnancy; Pre-eclampsia; Pregnancy