Beck, L. (Lara) (2017) De invloed van zwangerschapscholestase en de behandeling met Ursochol op deverhouding van macrofagen subset M1 en M2 en de TGR5 receptor. thesis, Medicine.
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Abstract
Introduction Intrahepatic cholestasis of pregnancy (ICP) is a disorder that can occur during the late second and third trimester of pregnancy. It is characterized by maternal pruritus and it can cause severe problems for the fetus like still birth or fetal distress. The etiology is not completely understood but the maternal immune system plays a pivotal role. Macrophage subsets M1 and M2 together with the bile acids receptor TGR5 seem to be important in developing this liver associated disease. Materials and Methods Using immunohistochemistry, macrophages and TGR5 receptor were analyzed in placental tissue of 10 patients with intrahepatic cholestasis of pregnancy with treatment with Ursochol, 10 patients with ICP without treatment, 20 healthy controls. Macrophages (CD68, CD206, IRF5), as well as the TGR5 expression, were analyzed using ImageScope and compared between the control group using Mann-Whitney U test; p<0.05. Results Macrophages were detected in the placentas of all groups, TGR5 receptor has also been detected in placenta tissue of all the groups. The frequency of macrophages and TGR5 did not differ in the patient group compared to the control group. However, a borderline significance (p=0.05) was found in maternal tissue for M2 macrophages when the patient group was divided (patients with treatment and patients without treatment). There were more M2 macrophages in de patient group without treatment compared to the patient group with treatment with Ursochol. A trend (p=0.09) for M2 macrophages was found in fetal tissue. There were more M2 macrophages in de patient group treated with Ursochol. Also the ratio between M1 and M2 showed differences towards a pro-inflammatory environment, although they were not significant, a trend (p=0.07) was seen. Conclusion We found no significant difference between different macrophage in the patient groups compared to the healthy controls. There is also no significant difference between TGR5 expression in the patient groups and the healthy controls. We did see differences between groups with or without Ursochol treatment, concluding that Ursochol plays a possible role in de immunology of intrahepatic cholestasis of pregnancy.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Dagelijks begeleider and Prins, Dr. J. R. and Facultair begeleider and Scherjon, Prof. dr. S. A. and Afdeling Afdeling Obstetrie & Gynaecologie Universitair Medi |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/555 |
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