Oxidative stress markers in intrahepatic cholestasis of pregnancy: a prospective controlled study

Intrahepatic cholestasis of pregnancy (ICP), characterized by skin pruritus and elevation of serum aminotransferase activity and bile acid concentration in the mother, is one of the most common liver disorders in pregnancy. It was proved that ICP might lead to fetal distress by triggering oxidative damage. Total bile acids (TBA) are an established marker for assessment of the severity of ICP. The aim of this study was to explore associations of TBA levels with levels of the oxidative stress markers 8-epimer of prostaglandin F2alpha (8-iso-PGF2α), superoxide dismutase (SOD) and glutathione peroxidase (Gpx) in ICP.

Maternal plasma levels of 8-iso-PGF2α, SOD and Gpx were examined in ICP patients (n=40) and normal pregnancy controls (n=47) using an enzyme-linked immunosorbent assay (ELISA) analysis.

Plasma levels of 8-iso-PGF2α and Gpx were significantly lower in ICP patients than in controls (p = 0.006 and 0.002, respectively), while no significant difference was observed in SOD levels between the two groups. Levels of 8-iso-PGF2α and TBA were negatively correlated (r = -0.277, p = 0.01, Spearman's correlation coefficient).

The clinical severity of ICP is closely related to the degree of lipid peroxidation, and the natural antioxidant system might fail to work effectively in the presence of lipid peroxidation damage in ICP.