妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)是特发于妊娠中晚期肝内胆汁淤积性疾病,以皮肤瘙痒、肝功能异常、胆汁酸水平升高、产后恢复正常为临床特点.研究显示,肠道菌群失调和内源性胆汁酸在胆汁淤积性肝病的发生发展中起着重要作用.孕期激素水平和能量代谢的剧烈变化可能引起了肠道菌群和胆汁酸构成的变化.肠道通透性的改变、胆汁酸的过度积累、胆汁酸转运体和核受体的异常表达都参与了胆汁淤积症的发病机制.本文就ICP中肠道菌群的变化及其在疾病发生发展中的作用机制进行综述,以及展望ICP的潜在治疗方法.
Research progress on the effect of gastrointestinal microbiota on intrahepatic cholestasis of pregnancy
Intrahepatic cholestasis of pregnancy(ICP),as an idiopathic disease,often occurs in the second and third trimester of pregnancy.It is characterized by maternal pruritus,abnormal liver function and raised serum bile acids which are resolved rapidly and spontaneously after delivery.It has been reported that abnormal intestinal microbiota and endogenous bile acids play important roles in the progression of cholestatic liver diseases.Dramatic changes in metabolic hormone levels and energy metabolism during pregnancy disrupt the microbiota composition and bile acid pool as well.Altered intestinal permeability,overaccumulation of bile acids,aberrant expression of bile acid transporters and nuclear receptors are all involved in the pathogenesis of cholestasis.This paper reviews the changes of intestinal flora and the mechanism of gastrointestinal microbiota in intrahepatic cholestasis of pregnancy,explore the potential treatments for ICP.
Intrahepatic pregnancy of cholestasisPregnancyGastrointestinal microbiotaBile acid
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