The impact of gut microbiome on intrahepatic cholestasis of pregnancy-systematic literature review.

In recent years, there has been a growing interest in the gut microbiome and its potential role in the etiopathogenesis of both gastrointestinal and extraintestinal diseases. Dysbiosis, characterized by a pathological alteration in the composition of the gut microbiome, has been implicated in various gastrointestinal diseases. This paradigm extends to pregnancy-specific conditions, including intrahepatic cholestasis of pregnancy (ICP). ICP exhibits a multifactorial etiopathogenesis, involving hormonal, genetic and environmental factors, among others. Despite growing scientific evidence, there is currently a lack of comprehensive reviews that specifically examine the causal mechanisms through which gut microbiota dysbiosis might contribute to the pathogenesis of ICP, as well as the resulting implications for the development of new targeted therapeutic approaches. Notably, shifts in microbial taxa and the depletion of bacteria involved in certain metabolic pathways have been observed in ICP. These findings suggest that alterations in the gut microbiome composition may contribute to the pathophysiology of ICP. Such microbiome-associated alterations may have important implications for risk stratification and early identification of patients at increased risk of adverse maternal and fetal outcomes. Further investigation into these microbial changes and molecular pathways could offer novel insights and identify potential pharmacological targets for ICP development and management. In particular, modulation of the gut microbiome could represent a future adjunctive strategy to existing therapeutic approaches, potentially improving disease monitoring and individualized management. The precise role of gut microbiome composition in the management and treatment of ICP is still not fully understood, highlighting the need for a systematic review to synthesize existing evidence and identify critical gaps relevant to the future development of screening, prevention, and targeted therapeutic strategies.