[Expression and significance of interleukin-18, 12 and tumor necrosis factor-α in intrahepatic cholestasis of pregnancy]

Objective: To investigate the effect of Interleukin (IL)-18, IL-12 and tumor necrosis factor-α (TNF-α) in hepatic injury in intrahepatic cholestasis of pregnancy (ICP).
Methods: Sixty-two cases of ICP patients (ICP group), 30 cases of normal pregnant women (control group) and 30 cases of hepatitis B (HBV) women (hepatitis group) were recruited. Serum IL-18, IL-12 and TNF-α were examined by ELISA. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined by automatic biochemical analysis instrument.
Results: (1) In hepatitis group, serum concentrations of IL-18, IL-12 and TNF-α were (256 ± 51) ng/L, (122 ± 96) ng/L and (207 ± 3) ng/L; serum levels of ALT and AST were (363 ± 174) U/L and (359 ± 237) U/L, respectively. In ICP group, serum concentrations of IL-18, IL-12 and TNF-α were (72 ± 32) ng/L, (42 ± 28) ng/L and (48 ± 14) ng/L; serum levels of ALT and AST were (201 ± 128) U/L and (132 ± 87) U/L, respectively.While in control group, serum concentrations of IL-18, IL-12 and TNF-α were (43 ± 13) ng/L, (10 ± 3) ng/L and (33 ± 9) ng/L; serum levels of ALT and AST were (13 ± 4) U/L and (15 ± 3) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in hepatitis group were significantly higher than those in ICP group and control group (P < 0.05). Serum IL-18, IL-12, TNF-α, ALT and AST levels in ICP group were significantly higher than those in control group(P < 0.05). (2) In severe ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (81 ± 32) ng/L, (50 ± 25) ng/L and (50 ± 14) ng/L; serum levels of ALT and AST were (269 ± 111) U/L and (181 ± 73) U/L. In mild ICP subgroup, serum concentrations of IL-18, IL-12 and TNF-α were (48 ± 18) ng/L, (17 ± 4) ng/L and (40 ± 10) ng/L; serum levels of ALT and AST were (87 ± 46) U/L and (50 ± 21) U/L, respectively. Serum IL-18, IL-12, TNF-α, ALT and AST levels in severe ICP subgroup were significantly higher than those in mild ICP subgroup and control group (P < 0.05). And serum ALT and AST levels in mild ICP subgroup were significantly higher than those in control group (P < 0.05). (3) There were 16 cases with preterm birth (50%, 16/32) and 10 cases with meconium-stained amniotic fluid (31%, 10/32) in severe ICP subgroup, significantly higher than those in mild ICP subgroup (P < 0.05), which contained 2 preterm births (7%, 2/30) and 1 meconium-stained amniotic fluid (3%, 1/30). While in control group, the numbers were 1 (3%, 1/30) and 1 (3%, 1/30), respectively. As for the cases of neonates whose 1 minute Apgar score were not more than 7, there were 2 cases, 1 case and 1 case in severe ICP subgroup, mild ICP subgroup and control group, respectively, which showed no significant difference (P > 0.05).
Conclusion: Serum IL-18, IL-12 and TNF-α may be involved in the process of hepatic injury of ICP.