Molecular Pathogenesis of Intrahepatic Cholestasis of Pregnancy

Figure 2

The role of hormones in the pathogenesis of ICP. Estrogen can regulate two proteins related to bile acid homeostasis, BESP, and MRP2, among which E2 can inhibit BESP through the interaction of ER-α and FXR; the metabolism of sulfated progesterone can activate GPBAR1 or TGR5 and cause transinhibition of BSEP-mediated bile acid efflux. Epiallopregnanolone sulfate can inhibit the expression of BESP. Prolactin can lead to a decrease in the concentration of bicarbonate in the blood. Adjustment events are displayed with arrows.