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Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects

Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained distressing pruritus in the mother and poses significant risk to the fetus of perinatal mortality. Occurring in the second and third trimester, the serum bile acid and aminotransferase are usually elevated in ICP patients. U...

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Autores principales: Shan, Dan, Dai, Siyu, Chen, Qian, Xie, Yupei, Hu, Yayi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500604/
https://www.ncbi.nlm.nih.gov/pubmed/37719856
http://dx.doi.org/10.3389/fphar.2023.1218432
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author Shan, Dan
Dai, Siyu
Chen, Qian
Xie, Yupei
Hu, Yayi
author_facet Shan, Dan
Dai, Siyu
Chen, Qian
Xie, Yupei
Hu, Yayi
author_sort Shan, Dan
collection PubMed
description Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained distressing pruritus in the mother and poses significant risk to the fetus of perinatal mortality. Occurring in the second and third trimester, the serum bile acid and aminotransferase are usually elevated in ICP patients. Ursodeoxycholic acid (UDCA) is the first line drug for ICP but the effectiveness for hepatoprotection is to a certain extent. In ICP patients with severe liver damage, combination use of hepatoprotective agents with UDCA is not uncommon. Herein, we reviewed the current clinical evidence on application of hepatoprotective agents in ICP patients. The underlying physiological mechanisms and their therapeutic effect in clinical practice are summarized. The basic pharmacologic functions of these hepatoprotective medications include detoxification, anti-inflammation, antioxidation and hepatocyte membrane protection. These hepatoprotective agents have versatile therapeutic effects including anti-inflammation, antioxidative stress, elimination of free radicals, anti-steatohepatitis, anti-fibrosis and anti-cirrhosis. They are widely used in hepatitis, non-alcoholic fatty liver disease, drug induced liver injury and cholestasis. Evidence from limited clinical data in ICP patients demonstrate reliable effectiveness and safety of these medications. Currently there is still no consensus on the application of hepatoprotective agents in ICP pregnancies. Dynamic monitoring of liver biochemical parameters and fetal condition is still the key recommendation in the management of ICP pregnancies.
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spelling pubmed-105006042023-09-15 Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects Shan, Dan Dai, Siyu Chen, Qian Xie, Yupei Hu, Yayi Front Pharmacol Pharmacology Intrahepatic cholestasis of pregnancy (ICP) is characterized by unexplained distressing pruritus in the mother and poses significant risk to the fetus of perinatal mortality. Occurring in the second and third trimester, the serum bile acid and aminotransferase are usually elevated in ICP patients. Ursodeoxycholic acid (UDCA) is the first line drug for ICP but the effectiveness for hepatoprotection is to a certain extent. In ICP patients with severe liver damage, combination use of hepatoprotective agents with UDCA is not uncommon. Herein, we reviewed the current clinical evidence on application of hepatoprotective agents in ICP patients. The underlying physiological mechanisms and their therapeutic effect in clinical practice are summarized. The basic pharmacologic functions of these hepatoprotective medications include detoxification, anti-inflammation, antioxidation and hepatocyte membrane protection. These hepatoprotective agents have versatile therapeutic effects including anti-inflammation, antioxidative stress, elimination of free radicals, anti-steatohepatitis, anti-fibrosis and anti-cirrhosis. They are widely used in hepatitis, non-alcoholic fatty liver disease, drug induced liver injury and cholestasis. Evidence from limited clinical data in ICP patients demonstrate reliable effectiveness and safety of these medications. Currently there is still no consensus on the application of hepatoprotective agents in ICP pregnancies. Dynamic monitoring of liver biochemical parameters and fetal condition is still the key recommendation in the management of ICP pregnancies. Frontiers Media S.A. 2023-08-31 /pmc/articles/PMC10500604/ /pubmed/37719856 http://dx.doi.org/10.3389/fphar.2023.1218432 Text en Copyright © 2023 Shan, Dai, Chen, Xie and Hu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Shan, Dan
Dai, Siyu
Chen, Qian
Xie, Yupei
Hu, Yayi
Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title_full Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title_fullStr Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title_full_unstemmed Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title_short Hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
title_sort hepatoprotective agents in the management of intrahepatic cholestasis of pregnancy: current knowledge and prospects
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500604/
https://www.ncbi.nlm.nih.gov/pubmed/37719856
http://dx.doi.org/10.3389/fphar.2023.1218432
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