FXR、BSEP在ICP胎盘胆酸转运中的作用机制研究  

Mechanism of FXR receptor and BSEP on bile acid transport in placenta of ICP

作　　者：黄健容[1] 刘建[1] 常淑芳[1] 

机构地区：[1]重庆医科大学附属第二医院,400010

出　　处：《重庆医学》2006年第21期1949-1950,1953,共3页Chongqing medicine

基　　金：重庆市医学科研资助项目(03-2-049)

摘　　要：目的研究胎盘在妊娠期肝内胆汁淤积症(ICP)胆汁酸转运中的作用,从胎盘角度探讨ICP的发病机制。方法采用免疫组化法测定ICP(ICP组)和正常晚期妊娠(对照组)胎盘上法尼醇X受体(FXR)、胆盐输出泵(BSEP)的表达,同时用放免法测定母体静脉血和脐静脉血甘胆酸(CG)水平。结果(1)ICP组母血CG、脐血CG均明显高于正常妊娠组(P<0.05);ICP组脐血CG与母血CG水平具有明显相关性(r=0.522,P<0.01),但脐血明显低于母体水平,二者差异有统计学意义。而正常组脐血与母血CG差异无统计学意义(P>0.05)。(2)首次在胎盘上发现有FXR的表达,其表达水平在ICP及正常妊娠胎盘差异有统计学意义(P<0.05)。(3)BSEP在正常妊娠胎盘上的表达明显增高,而在ICP胎盘表达减低。结论胎盘存在胆酸的载体转运,在ICP时,胎盘的这种转运可能发生了改变;胎盘上FXR、BSEP的表达异常引起的胆酸转运改变可能是ICP发病机制之一。Objective To explore the pathogenesis of intrahepatic cholestasis of pregnancy（ICP） from placenta. Methods The expression of FXR and BSEP in placenta from ICP patients and normal late pregnancy womem were detected by immunohistochemistry, and CG levels were tested in mother blood and umbilical venous blood from both groups by radioimmunoassay. Results （1） The CG levels in mother blood and umbilical venous blood in ICP were higher than that of normal pregnancy（P〈0.05） ;the CG level in mother blood was related to umbilical venous blood in ICP, but the CG level in umbilical venous blood was lower than in mother blood . There was no difference in normal pregnancy （P〉0.05）. （2） The expression of FXR in placenta was found,which was more in ICP than in normal late pregnancy（P〈0.05）. （3）The expression of BSEP in placenta was positive in normal pregnancy, negative in ICP. Conclusion There might be initiative transport of bile acid against concentration in placenta, which might be effected in ICP. The abnormal expression of FXR and BSEP in placenta resulting in transporting changes of bile acid might be one of the mechanism of ICP.

关 键 词：妊娠 肝内胆汁淤积 胎盘 核受体 胆酸 

分 类 号：R714.25[医药卫生—妇产科学]