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Bile acids evoke placental inflammation by activating Gpbar1/NF-κB pathway in intrahepatic cholestasis of pregnancy Free
YouHua Zhang1,†, YouDong Pan1,†, ChangDong Lin1,†, YaJuan Zheng1, Hao Sun1, HaiLong Zhang1, JunLei Wang1, MengYa Yuan1, Tao Duan2,*, QiaoLing Du2,*, and JianFeng Chen1,*
1State Key Laboratory of Cell Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China
2Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200040, China *Correspondence to:JianFeng Chen, E-mail: jfchen@sibcb.ac.cn; QiaoLing Du, E-mail: qldu2004@126.com; Tao Duan, E-mail: tduan@yahoo.com
J Mol Cell Biol, Volume 8, Issue 6, December 2016, 530-541,  https://doi.org/10.1093/jmcb/mjw025
Keyword: fetal outcome G protein-coupled receptor maternal cholestasis placental inflammation ursodeoxycholic acid

Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder with potentially deleterious consequences for fetuses. Although a clear correlation between the elevated levels of maternal serum bile acids and deficient fetal outcome has been established in clinical practice, the underlying mechanisms remain elusive. Herein, we report that bile acids induce NF-κB pathway activation via G protein-coupled bile acid receptor 1 (Gpbar1), with consequent upregulation of inflammatory genes in trophoblasts, leading to aberrant leukocyte infiltration and inflammation in placenta. Ursodeoxycholic acid (UDCA), a drug used clinically to treat ICP, competes with other bile acids for binding with Gpbar1 and thus inhibits bile acid-induced inflammatory response in trophoblasts and improves fetal survival in pregnant rats with obstructive cholestasis. Notably, inhibition of NF-κB by andrographolide is more effective than UDCA in benefiting placentas and fetuses. Thus, anti-inflammation therapy targeting Gpbar1/NF-κB pathway could be effective in suppressing bile acid-induced inflammation and alleviating ICP-associated fetal disorders.