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ATP8B1 mutations in British cases with intrahepatic cholestasis of pregnancy.
[benign recurrent intrahepatic cholestasis]
Intrahepatic
cholestasis
of
pregnancy
(
ICP
)
affects
approximately
0
.
7
%
of
pregnancies
in
the
UK
and
is
associated
with
prematurity
,
fetal
distress
,
and
intrauterine
death
.
Homozygous
mutations
in
the
ATP
8
B
1
gene
cause
cholestasis
with
a
normal
serum
gamma-glutamyl
transpeptidase
(
gamma-
GT
)
,
and
have
been
reported
in
two
forms
of
cholestasis
:
progressive
familial
intrahepatic
cholestasis
type
1
(
PFIC
1
)
and
benign
recurrent
intrahepatic
cholestasis
(
BRIC
)
.
To
establish
whether
mutations
in
ATP
8
B
1
are
associated
with
ICP
in
British
casesSixteen
well
phenotyped
women
with
ICP
without
raised
gamma-
GT
were
selected
for
sequence
analysis
.
Subsequently
,
182
patients
and
120
controls
were
examined
for
the
presence
of
the
variants
detected
.
All
coding
exons
were
sequenced
in
16
cases
.
Eight
ICP
cases
,
including
two
women
carrying
a
mutation
,
were
investigated
using
in
vivo
hepatic
(
31
)
P
magnetic
resonance
spectroscopy
(
MRS
)
RESULTS
:
Two
heterozygous
ATP
8
B
1
transitions
(
208
G
>
A
and
2599
C
>
T
)
that
resulted
in
amino
acid
substitutions
were
identified
;
208
G
>
A
was
identified
in
three
cases
.
MRS
revealed
an
increased
phosphodiester
signal
(
Mann-
Whitney
U
test
,
p
=
0
.
03
)
and
a
decreased
phosphomonoester
/
phosphodiester
ratio
(
p
=
0
.
04
)
in
ICP
cases
compared
with
controls
.
We
were
able
to
demonstrate
ATP
8
B
1
mutations
in
ICP
.
MRS
studies
suggest
that
susceptibility
to
ICP
is
associated
with
a
relative
rise
in
biliary
phospholipid
.
These
data
also
suggest
that
MRS
may
be
used
for
non-invasive
assessment
of
the
liver
and
biliary
constituents
in
cholestasis
.
Diseases
Validation
Diseases presenting
"mutations in the atp8b1 gene"
symptom
benign recurrent intrahepatic cholestasis
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