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Li P, Jiang Y, Xie M, You Y. Factors associated with intrahepatic cholestasis of pregnancy and its influence on maternal and infant outcomes. Medicine (Baltimore) 2023; 102:e32586. [PMID: 36607861 PMCID: PMC9829298 DOI: 10.1097/md.0000000000032586] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to investigate the clinical features and risk factors of intrahepatic cholestasis of pregnancy (ICP) and its effect on pregnancy outcomes. The data from 300 pregnant women with ICP and 300 pregnant women without ICP admitted from July 2015 to December 2016 at Changsha Maternal and Child Health Hospital were collected. The factors associated with ICP were examined. The family history of ICP, twin pregnancies, number of births, hypertensive disorder of pregnancy (HDP), gestational diabetes, hyperlipidemia, hepatitis virus infection, and in vitro fertilization and embryo transfer, differed significantly between the 2 groups (all P < .05). The multivariable analysis showed that body mass index at delivery, number of births, HDP, gestational diabetes, hyperlipidemia, and hepatitis virus infection were associated with ICP (all P < .05). The incidence of abnormal amniotic fluid and premature births in the ICP group were significantly higher than in the control group (all P < .05). ICP is associated with BMI at delivery, number of births, HDP, gestational diabetes, hyperlipidemia, and hepatitis virus infection. ICP greatly influences pregnancy outcomes.
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Affiliation(s)
- Ping Li
- Obstetrics Department, the Maternal and Child Health Hospital of Hunan Province, Hunan, China
- * Correspondence: Ping Li, Obstetrics Department, the Maternal and Child Health Hospital of Hunan Province, Changsha 410008, Hunan, China (e-mail: )
| | - Yurong Jiang
- Obstetrics Department, the Maternal and Child Health Hospital of Hunan Province, Hunan, China
| | - Mina Xie
- Obstetrics Department, Changsha Maternal and Child Health Care Hospital, Hunan, China
| | - Yiping You
- Obstetrics Department, the Maternal and Child Health Hospital of Hunan Province, Hunan, China
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Xi S, Zheng X, Li X, Jiang Y, Wu Y, Gong J, Jie Y, Li Z, Cao J, Sha L, Zhang M, Chong Y. Activated Hepatic Stellate Cells Induce Infiltration and Formation of CD163 + Macrophages via CCL2/CCR2 Pathway. Front Med (Lausanne) 2021; 8:627927. [PMID: 33614685 PMCID: PMC7893116 DOI: 10.3389/fmed.2021.627927] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Activated hepatic stellate cells (aHSCs) regulate the function of immune cells during liver fibrosis. As major innate cells in the liver, macrophages have inducible plasticity. Nevertheless, the mechanisms through which aHSCs regulate macrophages' phenotype and function during liver fibrosis and cirrhosis remain unclear. In this study, we examined the immunoregulatory function of aHSCs during liver fibrosis and explored their role in regulating macrophage phenotype and function. Methods: A total of 96 patients with different stages of chronic hepatitis B-related liver fibrosis were recruited in the study. Metavir score system was used to evaluate the degree of fibrosis. The expression of hepatic CCL2 and M2 phenotype macrophage marker CD163 were detected by immunohistochemistry, and the relationship among hepatic CD163, CCL2, and fibrosis scores were also explored. In the in vitro model, the aHSCs isolated from human liver tissues and THP-1-derived M0-type macrophages (M0MΦ) were co-cultured to observe whether and how aHSCs regulate the phenotype and function of macrophages. To explore whether CCL2/CCR2 axis has a crucial role in macrophage phenotypic changes during liver fibrosis, we treated the M0MΦ with recombinant human CCL2 or its specific receptor antagonist INCB-3284. Furthermore, we used LX2 and TGF-β-activated LX2 to mimic the different activation statuses of aHSCs to further confirm our results. Results: In patients, the infiltration of M2 macrophages increased during the progression of liver fibrosis. Intriguingly, as a key molecule for aHSC chemotactic macrophage aggregation, CCL2 markedly up-regulated the expression of CD163 and CD206 on the macrophages, which was further confirmed by adding the CCR2 antagonist (INCB 3284) into the cell culture system. In addition, the TGF-β stimulated LX2 further confirmed that aHSCs up-regulate the expression of CD163 and CD206 on macrophages. LX2 stimulated with TGF-β could produce more CCL2 and up-regulate other M2 phenotype macrophage-specific markers, including IL-10, ARG-1, and CCR2 besides CD163 and CD206 at the gene level, indicating that the different activation status of aHSCs might affect the final phenotype and function of macrophages. Conclusions: The expression of the M2 macrophage marker increases during liver fibrosis progression and is associated with fibrosis severity. AHSCs can recruit macrophages through the CCL2/CCR2 pathway and induce M2 phenotypic transformation.
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Affiliation(s)
- Sujuan Xi
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China.,The Reproductive Medical Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xiaoyan Zheng
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiangyong Li
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuming Jiang
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuankai Wu
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiao Gong
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Yusheng Jie
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Zhanyi Li
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Jing Cao
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Liuping Sha
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min Zhang
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
| | - Yutian Chong
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-sen University, Guangzhou, China
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Jiang R, Wang T, Yao Y, Zhou F, Huang X. Hepatitis B infection and intrahepatic cholestasis of pregnancy: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21416. [PMID: 32756142 PMCID: PMC7402766 DOI: 10.1097/md.0000000000021416] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Viral hepatitis type B is caused by hepatitis B virus (HBV) infection. Several studies have linked HBV infection to a higher risk of developing intrahepatic cholestasis of pregnancy (ICP), although some give contradictory results. To investigate the association and estimated risk of ICP in patients with HBV infection, we conducted this meta-analysis to summarize all available evidence. METHODS This study consists of 2 meta-analyses. A literature search was performed using MEDLINE and EMBASE from inception to July 2019. The first study included studies that reported associations between HBV infection and the risk of ICP. The second analysis included studies comparing the risk of HBV infection in ICP patients with those without ICP. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effect, inverse variance method. RESULTS Four studies were included in both analyses. The OR of ICP in HBV-infected pregnant women compared with non-HBV pregnant women was 1.68 (95% CI 1.43-1.97; I = 0%). The OR of HBV infection among ICP patients compared with non-ICP patients was 1.70 (95% CI 1.44-2.01; I = 0%). CONCLUSIONS Our meta-analysis demonstrates not only a higher risk of ICP among HBV-infected pregnant women but also an increased risk of HBV infection among ICP patients. These findings suggest that HBV is a high-risk factor for ICP and screening for hepatitis B in women with ICP symptoms may be beneficial.
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Wei J, Gronert K. Eicosanoid and Specialized Proresolving Mediator Regulation of Lymphoid Cells. Trends Biochem Sci 2018; 44:214-225. [PMID: 30477730 DOI: 10.1016/j.tibs.2018.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/12/2022]
Abstract
Eicosanoids and specialized proresolving mediators (SPMs) regulate leukocyte function and inflammation. They are ideally positioned at the interface of the innate and adaptive immune responses when lymphocytes interact with leukocytes. Receptors for leukotriene B4 (LTB4), prostaglandin E2 (PGE2), and SPMs are expressed on lymphocytes. Evidence points toward an essential role of these lipid mediators (LMs) in direct regulation of lymphocyte functions. SPMs, which include lipoxins, demonstrate comprehensive protective actions with lymphocytes. LTB4 and PGE2 regulation of lymphocytes is diverse and depends on the interaction of lymphocytes with other cells. Importantly, both LTB4 and PGE2 are essential regulators of T cell antitumor activity. These LMs are attractive therapeutic targets to control dysregulated innate and adaptive immune responses, promote lymphocyte antitumor activity, and prevent tumor immune evasion.
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Affiliation(s)
- Jessica Wei
- Vision Science Program, School of Optometry, Infectious Disease and Immunity Program, University of California Berkeley, Berkeley, CA 94720, USA
| | - Karsten Gronert
- Vision Science Program, School of Optometry, Infectious Disease and Immunity Program, University of California Berkeley, Berkeley, CA 94720, USA.
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Li X, Su Y, Hua X, Xie C, Liu J, Huang Y, Zhou L, Zhang M, Li X, Gao Z. Levels of hepatic Th17 cells and regulatory T cells upregulated by hepatic stellate cells in advanced HBV-related liver fibrosis. J Transl Med 2017; 15:75. [PMID: 28399886 PMCID: PMC5387242 DOI: 10.1186/s12967-017-1167-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 03/14/2017] [Indexed: 02/08/2023] Open
Abstract
Background Liver fibrosis which mainly occurs upon chronic hepatitis virus infection potentially leads to portal hypertension, hepatic failure and hepatocellular carcinoma. However, the immune status of Th17 and Treg cells in liver fibrosis is controversial and the exact mechanisms remain largely elusive. Methods Liver tissues and peripheral blood were obtained simultaneously from 32 hepatitis B virus infected patients undergoing surgery for hepatocellular carcinoma at the medical center of Sun Yat-sen University. Liver tissues at least 3 cm away from the tumor site were used for the analyses. Levels of Th17 cells and regulatory T cells were detected by flow cytometry analysis and immunohistochemistry. In vitro experiment, we adopted magnetic cell sorting to investigate how hepatic stellate cells regulate the levels of Th17 cells and regulatory T cells. Results We found that hepatic Th17 cells and regulatory T cells were increased in patients with advanced stage HBV-related liver fibrosis. Hepatic stellate cells upregulated the levels of Th17 cells and regulatory T cells via PGE2/EP2 and EP4 pathway. Conclusions We found that the increased levels of Th17 cells and regulatory T cells were upregulated by hepatic stellate cells. These results may provide insight into the role of hepatic stellate cells and Th17 cells and regulatory T cells in the persistence of fibrosis and into the occurrence of hepatocellular carcinoma following cirrhosis. Electronic supplementary material The online version of this article (doi:10.1186/s12967-017-1167-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaoyan Li
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China
| | - Yujie Su
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China
| | - Xuefeng Hua
- Department of Transplant Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Chan Xie
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China
| | - Jing Liu
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China
| | - Yuehua Huang
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.,Guangdong Province Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liang Zhou
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China
| | - Min Zhang
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.,Guangdong Province Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China
| | - Xu Li
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, No 210 Jixi Road, Hefei, 230022, Anhui Province, China.
| | - Zhiliang Gao
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China. .,Guangdong Province Key Laboratory of Liver Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. .,Key Laboratory of Tropical Disease Control (Sun Yat-sen University), Ministry of Education, Guangzhou, China.
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Liu J, Yang XF. Role of cyclooxygenase-2 in immune response in liver fibrosis and mechanisms involved. Shijie Huaren Xiaohua Zazhi 2017; 25:702-708. [DOI: 10.11569/wcjd.v25.i8.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cyclooxygenase-2 (COX-2), an inducible enzyme, is almost not expressed in normal human and rat liver tissues, but is highly expressed in liver tissues of patients with chronic hepatitis and cirrhosis. Inhibition or interference of COX-2 expression can significantly inhibit the formation of hepatic fibrosis in rats, suggesting that COX-2 is involved in the occurrence and development of hepatic fibrosis; however, the underlying mechanism is unclear. Recent studies have shown that the role of COX-2 in the development of hepatic fibrosis may be related to immune response. In this paper, we review the role of COX-2 and its metabolites in the immune response in liver fibrosis, with an aim to provide a theoretical basis for clinical prevention and treatment of hepatic fibrosis.
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Zhu B, Lin N, Zhang M, Zhu Y, Cheng H, Chen S, Ling Y, Pan W, Xu R. Activated hepatic stellate cells promote angiogenesis via interleukin-8 in hepatocellular carcinoma. J Transl Med 2015; 13:365. [PMID: 26593962 PMCID: PMC4655083 DOI: 10.1186/s12967-015-0730-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 11/13/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Chemokines have been recognized as important modulators of angiogenesis, and they play critical roles in the development and metastasis of hepatocellular carcinoma (HCC), although their origins and latent molecular mechanisms remain elusive. The aim of this study was to investigate how activated hepatic stellate cells (a-HSCs) promote angiogenesis in HCC. METHODS A total of 22 HCC patients were enrolled randomly. We used immunohistochemistry, western blotting, and enzyme-linked immunosorbent assay (ELISA) to analyse the production of interleukin-8 (IL-8) in a-HSCs derived from HCC tissues. The angiogenic effects of IL-8 in vitro and in vivo were assessed by ELISA, real-time quantitative polymerase chain reaction, capillary tube formation assay, and chick embryo chorioallantoic membrane assay. RESULTS The present study showed that IL-8 was enriched predominantly in the tumour stroma of HCC tissues and was mainly derived from a-HSCs, rather than from hepatoma cells, in vivo and in vitro. Angiogenesis was most active at the invading edge, which was close to the a-HSCs. The angiogenic effect was dramatically attenuated by an IL-8 neutralizing antibody both in vitro and in vivo. Moreover, the IL-8 neutralizing antibody down-regulated Ser727-phosphorylated STAT3 levels in hepatoma cells treated with a-HSCs conditioned medium. CONCLUSIONS These findings reveal that a-HSCs within the stroma of HCC contribute to tumour angiogenesis via IL-8.
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Affiliation(s)
- Bing Zhu
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Nan Lin
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Min Zhang
- Department of Infectious Diseases, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Liver Disease Research, Guangzhou, China.
| | - Yong Zhu
- Department of Gastrointestinal Surgery, The 4th Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Huanhuan Cheng
- Department of Ophthalmology, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Shuxian Chen
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Yunbiao Ling
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Weidong Pan
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Ruiyun Xu
- Department of Hepatobiliary Surgery, The 3rd Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
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