کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6101647 | 1211107 | 2015 | 8 صفحه PDF | دانلود رایگان |
Background & AimsIntrahepatic cholestasis of pregnancy (ICP) is defined by pruritus, elevated total fasting serum bile salts (TBS) and transaminases, and an increased risk of adverse fetal outcome. An accurate diagnostic marker is needed. Increased serum autotaxin correlates with cholestasis-associated pruritus. We aimed at unraveling the diagnostic accuracy of autotaxin in ICP.MethodsSerum samples and placental tissue were collected from 44 women with uncomplicated pregnancies and 105 with pruritus and/or elevated serum transaminases. Autotaxin serum levels were quantified enzymatically and by Western blotting, autotaxin gene expression by quantitative PCR.ResultsSerum autotaxin was increased in ICP (mean ± SD: 43.5 ± 18.2 nmol mlâ1 minâ1, n = 55, p <0.0001) compared to other pruritic disorders of pregnancy (16.8 ± 6.7 nmol mlâ1 minâ1, n = 33), pre-eclampsia complicated by HELLP-syndrome (16.8 ± 8.9 nmol mlâ1 minâ1, n = 17), and pregnant controls (19.6 ± 5.7 nmol mlâ1 minâ1, n = 44). Longitudinal analysis during pregnancy revealed a marked rise in serum autotaxin with onset of ICP-related pruritus. Serum autotaxin was increased in women taking oral contraceptives. Increased serum autotaxin during ICP was not associated with increased autotaxin mRNA in placenta. With a cut-off value of 27.0 nmol mlâ1 minâ1, autotaxin had an excellent sensitivity and specificity in distinguishing ICP from other pruritic disorders or pre-eclampsia/HELLP-syndrome. Serum autotaxin displayed no circadian rhythm and was not influenced by food intake.ConclusionsIncreased serum autotaxin activity represents a highly sensitive, specific and robust diagnostic marker of ICP, distinguishing ICP from other pruritic disorders of pregnancy and pregnancy-related liver diseases. Pregnancy and oral contraception increase serum autotaxin to a much lesser extent than ICP.
Journal: Journal of Hepatology - Volume 62, Issue 4, April 2015, Pages 897-904