Immunology of hepatic diseases during pregnancy

Semin Immunopathol. 2016 Nov;38(6):669-685. doi: 10.1007/s00281-016-0573-1. Epub 2016 Jun 20.

Abstract

The mother's immune system has to adapt to pregnancy accepting the semi-allograft fetus and preventing harmful effects to the developing child. Aberrations in feto-maternal immune adaptation may result in disease of the mother, such as liver injury. Five pregnancy-associated liver disorders have been described so far, however, little is known concerning immune alterations promoting the respective disease. These liver disorders are pre-eclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP), acute fatty liver, hyperemesis gravidarum, and intrahepatic cholestasis of pregnancy. On the other hand, pre-existing autoimmune liver injury of the mother can be affected by pregnancy. This review intends to summarize current knowledge linking feto-maternal immunology and liver inflammation with a special emphasis on novel potential biomarkers.

Keywords: Acute fatty liver of pregnancy; Auto immune hepatitis; HELLP; Hyperemesis gravidarum; Intrahepatic cholestasis of pregnancy; Pre-eclampsia; Pregnancy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • Cholestasis, Intrahepatic / diagnosis
  • Cholestasis, Intrahepatic / epidemiology
  • Cholestasis, Intrahepatic / etiology
  • Cholestasis, Intrahepatic / metabolism
  • Female
  • HELLP Syndrome / diagnosis
  • HELLP Syndrome / etiology
  • HELLP Syndrome / metabolism
  • Humans
  • Immune Tolerance
  • Immunity*
  • Immunization
  • Incidence
  • Liver / immunology
  • Liver / metabolism
  • Liver / pathology
  • Liver Diseases / diagnosis*
  • Liver Diseases / etiology*
  • Liver Diseases / metabolism
  • Liver Diseases / therapy
  • Pre-Eclampsia / diagnosis
  • Pre-Eclampsia / etiology
  • Pre-Eclampsia / metabolism
  • Pre-Eclampsia / therapy
  • Pregnancy
  • Pregnancy Complications*
  • Prognosis

Substances

  • Biomarkers