The Diversification Of Vitamin D Receptor And Th1/Th2 Cytokines In Peripheral Blood Of Patient With Intraheptic Cholestasis Of Pregnancy

Objective: To study the relationship between the expression of the vitamin D receptor (VDR) and Th1/Th2 cytokines (IFN-γ/IL-4) profile in the peripheral blood of patients with intrahepatic cholestasis of pregnancy (ICP),so as to investigate the pathogen of ICP.Methods : There were 31 pregnant women with intraheptic cholestasis of pregnancy and 31 normal pregnant women in the study. The T helper cell type-1 (Th1) cytokine [interferon-gamma (IFN-γ)] and T helper cell type-2 (Th2) cytokine [interleukin-4 (IL-4)] in the serum of patients with ICP (ICP group)and normal pregnant women (normal group,NP) were measured by enzyme linked immuno-sorbent assay (ELISA);The vitamin D receptor (VDR) expression in the peripheral blood mononuclear cells was examined by real time fluorescent quantitative reverse transcriptase polymerase chain reaction (real-time qRT-PCR) in the two groups. Glyceraldehyde-3-phosphate Dehydrogease (GAPDH) was used as an endogenous reference. VDR expression levelwere used by the 2^{-ΔΔCT} method in the two group.Results1. The concentrations of IFN-γin ICP group [(230.93±36.04)pg/ml] was significantly higher than those in normal group [(138.37±25.08) pg/ml] (P<0.01). But there were no significant differences in the concentrations of IL-4 between ICP group [(9.99±3.19)pg/ml] and normal group [(8.58±2.43)pg/ml] (P>0.05).The IFN-γ/IL-4 ratio in ICP group(24.56±6.91) was higher than those in normal group(17.13±4.84) (P<0.05).2. VDR expression in the peripheral blood mononuclear cells was found to be significantly lower(0.4) in all patients with ICP than that in normal pregnancy(1.0),P<0.01.3. In ICP group the correlation between the expression of VDR and the levels of IFN-γwas significantly negative(r=-0.833,P<0.01); the correlation between the expression of VDR and the levels of IL-4 was not significant(r=-0.109,P>0.05); the correlation between the expression of VDR and IFN-γ/IL-4 ratio was negative , but the relation was not significant (r=-0.356,P=0.049<0.05).Conclusion: The cytokine profile shift from Th2-type to Th1-type in the peripheral blood, which may relate to the reduced expression of VDR in the peripheral blood mononuclear cells of the patients with ICP.