Dynamic Changes in Inflammatory markers in Intrahepatic Cholestasis of Pregnancy

Background and Aim: Intrahepatic cholestasis of pregnancy (ICP) is associated with raised liver enzymes, pruritus elevated fasting total bile acids (TBA) may lead to adverse perinatal outcomes such as preterm birth, meconium-stained liquor, stillbirth, foetal growth restriction etc. The change in inflammatory profile ICP association TBA not known. Methods: Patients (aged >21) confirmed diagnosis defined TBA>10 mol/L deranged LFT were screened, degree on visual analogue score (VAS) calculated. autoimmune disease, viral infection, obstructive biliary disorders excluded. Baseline blood samples incubated monoclonal antibodies (CD45, CD3, CD4, CD28, CD69) for surface intranuclear (T-Bet, GATA-3 & RoryT) per manufactures protocol. Immunophenotyping was performed flow-cytometer, FACS DIVA software used data analysis. Blood taken two time points, baseline the after delivery. Results: Five hundred twenty patients screened between December 2022 April 2023 at Antenatal care OPD PGIMER, Chandigarh. Finally, 13 cases (8 treatment naive 5 UDCA) included. mean age 29±3.1 years; 24.9 ±13.3 reduced 3.8±1.1 mol/L) post-delivery, VAS 7.54±1.71 which 2.42±0.93 following expression CD69 CD4+T-lymphocytes increased (5.79%,p=0.002),CD4+Th17+Tlymphocytes(4.79%,p=0.002)andCD4+Th1Th17++T-lymphocytes (0.55%, p=0.004%) significantly compared post-delivery (CD69:0.10%,CD4+Th17+T lymphocytes 0.55%, CD4+Th1Th17++T-lymphocytes 0.03%). UDCA showed reduction (CD69 2.5% p=0.013) 9.2%) whereas no difference found comparison CD4+Th17+T lymphocytes. Conclusion: have activity all subtypes CD4+T indicated by CD69, Th1Th17++T-lymphocytes. significant population persons.