Placental exosomal level of alanine aminotransferase is more accurate predictive biomarker of intrahepatic cholestasis of pregnancy than total bile acid

Abstract

Aims: As a serious liver abnormality, intrahepatic cholestasis of pregnancy (ICP) uniquely occurs in pregnant women. In the present study, we examined whether placental exosomes and their protein contents could serve as novel indicators to help early diagnosis of ICP. Methods: The current retrospective stratified study design included a 100 healthy pregnant females and a 100 patients with ICP. Plancental exosomes were isolated to determine the exosomal levels of alanine aminotransferase (ALT) and total bile acid (TBA). The predictive values of placental exosomal TBA and ALT were determined using receiver operating characteristic (ROC) curve analysis. Results: The placental exosomal TBA level did not exhibit any obvious differences between healthy and ICP pregnancies. Moreover, placental exosomal ALT level was significantly higher in ICP-affected pregnancy than healthy control. Analysis of the ROC curve further demonstrated that placental exosomal level of ALT yields better sensitivity and specificity to distinguish ICP patients from healthy individuals, than that of TBA. Conclusions: Placental exosomal ALT is a more accurate predictive biomarker of ICP than TBA and, therefore, can be employed with reliability as a characteristic abnormality in diagnosis of ICP.

Keywords

• ICP
• exosome
• TBA
• ALT
• biomarker
• receiver operating characteristic curve analysis