摘要目的 探讨组成型雄烷受体(CAR)在妊娠期肝内胆汁淤积症(ICP)孕妇胎盘合体滋养细胞中的表达及其临床意义.方法 收集2009年4月-2010年3月在重庆医科大学附属第一医院分娩的ICP孕妇的胎盘绒毛组织,其中ICP轻度孕妇10例(ICP轻度组),ICP重度孕妇10例(ICP重度组).同期健康晚期妊娠妇女10例为对照组.采用免疫组化链霉亲和素一生物素一过氧化物酶复合物(SABC)法检测胎盘组织中CAR蛋白的表达定位;采用逆转录(RT)-PCR技术检测CAR mRNA表达水平;蛋白印迹法检测CAR蛋白的表达水平.结果 (1)CAR表达定位在对照组和ICP轻度组胎盘合体滋养细胞中,着色较淡,呈淡棕黄色染色,着色部位主要在细胞质;在ICP重度组,CAR也主要定位在胎盘合体滋养细胞中,但着色部位主要在细胞核,呈棕黄色浓染.(2)对照组、ICP轻度组及重度组孕妇胎盘组织中CAR mRNA的表达水平分别为0.06±0.03、0.07 ±0.03及0.56 ±0.03,ICP重度组明显高于对照组和ICP轻度组,分别比较,差异均有统计学意义(P＜0.05);而ICP轻度组与对照组比较,差异无统计学意义(P＞0.05).(3)对照组、ICP轻度组及重度组孕妇胎盘组织中CAR蛋白的表达水平分别为0.74 ±0.03、0.79 ±0.03及1.02 ±0.04,ICP重度组与轻度组及对照组比较,差异均有统计学意义(P＜0.05);ICP轻度组与对照组比较,差异无统计学意义(P＞0.05).结论 ICP 孕妇尤其是ICP重度孕妇胎盘合体滋养细胞中CAR表达水平显著升高,其可能参与了维护胎盘的屏障功能,从而在ICP的发病中起到保护作用.

abstractsObjective To explore the expression and clinical significance of constitutive androstane receptor(CAR)in placenta syntrophoblast from patients with intrahepatic cholestasis of pregnancy(ICP).Methods Placenta were collected from women with ICP who delivered from April 2009 to March 2010 in First Affiliated Hospital of Chongqing Medical University.According to the severity of ICP,patients were classified into mild ICP group(n=10)and severe ICP group(n=10).Ten healthy pregnant women who delivered in the same period were chosen as control group.The location of CAR protein in placenta was studied by immunohistochemical streptavidin-biotin complex(SABC)method.CAR mRNA level was determined by reverse transcription(RT)-PCR technique and CAR protein expression level was determined by western blot.Results(1)CAR was located in the placenta syncytiotrophoblastic cells in control group and mild ICP group,showed light tan when stained,and was mainly in the cytoplasm.In severe ICP group,CAR was also located in placenta syncytiotrophoblastic cells but mainly in the nucleolus,showed dark tan when stained.(2)The mRNA expressions of CAR in control group,mild ICP group,severe ICP group were 0.06 ±0.03,0.07 ±0.03 and 0.56±0.03.respectively.CAR in severe ICP group was significantly higher than those in control group and mild ICP group(P＜0.05).The difference of mRNA between control group and mild ICP group wag not statistically significant(P＞0.05).(3)The CAR protein levels in control group,mild ICP group,severe ICP group were 0.74±0.03,0.79±01 03 and 1.02±0.04,respectively.CAR protein expression in the severe ICP group was significantly higher than the other two groups(P＜0.05).And there was no statistical significance between mild group and control group(P＞0.05).Conclusion In ICP women.especially severe ICP patients,the CAR expression in placenta syncytiotrophoblastic cells increased appreciably,which may be involved in the maintenance of placenta barrier function and protection in ICP pathogenesis.