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Omazić J, Viljetić B, Ivić V, Kadivnik M, Zibar L, Müller A, Wagner J. Early markers of gestational diabetes mellitus: what we know and which way forward? Biochem Med (Zagreb) 2021; 31:030502. [PMID: 34658643 PMCID: PMC8495622 DOI: 10.11613/bm.2021.030502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/28/2021] [Indexed: 12/11/2022] Open
Abstract
Women’s metabolism during pregnancy undergoes numerous changes that can lead to gestational diabetes mellitus (GDM). The cause and pathogenesis of GDM, a heterogeneous disease, are not completely clear, but GDM is increasing in prevalence and is associated with the modern lifestyle. Most diagnoses of GDM are made via the guidelines from the International Association of Diabetes and Pregnancy Study Groups (IADSPG), which involve an oral glucose tolerance test (OGTT) between 24 and 28 weeks of pregnancy. Diagnosis in this stage of pregnancy can lead to short- and long-term implications for the mother and child. Therefore, there is an urgent need for earlier GDM markers in order to enable prevention and earlier treatment. Routine GDM biomarkers (plasma glucose, insulin, C-peptide, homeostatic model assessment of insulin resistance, and sex hormone-binding globulin) can differentiate between healthy pregnant women and those with GDM but are not suitable for early GDM diagnosis. In this article, we present an overview of the potential early biomarkers for GDM that have been investigated recently. We also present our view of future developments in the laboratory diagnosis of GDM.
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Affiliation(s)
- Jelena Omazić
- Department of Laboratory and Transfusion Medicine, National Memorial Hospital Vukovar, Vukovar, Croatia.,Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Barbara Viljetić
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Vedrana Ivić
- Department of Medical Biology and Genetics, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Mirta Kadivnik
- Clinic of Obstetrics and Gynecology, University Hospital Center Osijek, Osijek, Croatia.,Department of Obstetrics and Gynecology, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Lada Zibar
- Department of Pathophysiology, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia.,Department of Nephrology, Clinical Hospital Merkur, Zagreb, Croatia
| | - Andrijana Müller
- Clinic of Obstetrics and Gynecology, University Hospital Center Osijek, Osijek, Croatia.,Department of Obstetrics and Gynecology, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
| | - Jasenka Wagner
- Department of Medical Biology and Genetics, Faculty of Medicine, J.J. Strossmayer University, Osijek, Croatia
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Gestational Diabetes Mellitus and Maternal Immune Dysregulation: What We Know So Far. Int J Mol Sci 2021; 22:ijms22084261. [PMID: 33923959 PMCID: PMC8073796 DOI: 10.3390/ijms22084261] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is an obstetric complication that affects approximately 5-10% of all pregnancies worldwide. GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy, and is characterized by exaggerated insulin resistance, a condition which is already pronounced in healthy pregnancies. Maternal hyperglycaemia ensues, instigating a 'glucose stress' response and concurrent systemic inflammation. Previous findings have proposed that both placental and visceral adipose tissue play a part in instigating and mediating this low-grade inflammatory response which involves altered infiltration, differentiation and activation of maternal innate and adaptive immune cells. The resulting maternal immune dysregulation is responsible for exacerbation of the condition and a further reduction in maternal insulin sensitivity. GDM pathology results in maternal and foetal adverse outcomes such as increased susceptibility to diabetes mellitus development and foetal neurological conditions. A clearer understanding of how these pathways originate and evolve will improve therapeutic targeting. In this review, we will explore the existing findings describing maternal immunological adaption in GDM in an attempt to highlight our current understanding of GDM-mediated immune dysregulation and identify areas where further research is required.
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Kieffer TEC, Laskewitz A, Scherjon SA, Faas MM, Prins JR. Memory T Cells in Pregnancy. Front Immunol 2019; 10:625. [PMID: 31001255 PMCID: PMC6455355 DOI: 10.3389/fimmu.2019.00625] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022] Open
Abstract
Adaptations of the maternal immune response are necessary for pregnancy success. Insufficient immune adaption is associated with pregnancy pathologies such as infertility, recurrent miscarriage, fetal growth restriction, spontaneous preterm birth, and preeclampsia. The maternal immune system is continuously exposed to paternal-fetal antigens; through semen exposure from before pregnancy, through fetal cell exposure in pregnancy, and through microchimerism after pregnancy. This results in the generation of paternal-fetal antigen specific memory T cells. Memory T cells have the ability to remember previously encountered antigens to elicit a quicker, more substantial and focused immune response upon antigen reencounter. Such fetal antigen specific memory T cells could be unfavorable in pregnancy as they could potentially drive fetal rejection. However, knowledge on memory T cells in pregnancy has shown that these cells might play a favorable role in fetal-maternal tolerance rather than rejection of the fetus. In recent years, various aspects of immunologic memory in pregnancy have been elucidated and the relevance and working mechanisms of paternal-fetal antigen specific memory T cells in pregnancy have been evaluated. The data indicate that a delicate balance of memory T cells seems necessary for reproductive success and that immunologic memory in reproduction might not be harmful for pregnancy. This review provides an overview of the different memory T cell subtypes and their function in the physiology and in complications of pregnancy. Current findings in the field and possible therapeutic targets are discussed. The findings of our review raise new research questions for further studies regarding the role of memory T cells in immune-associated pregnancy complications. These studies are needed for the identification of possible targets related to memory mechanisms for studies on preventive therapies.
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Affiliation(s)
- Tom E C Kieffer
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne Laskewitz
- Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sicco A Scherjon
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marijke M Faas
- Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Jelmer R Prins
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Mahmoud FF, Haines D, Dashti AA, El-Shazly S, Al-Najjar F. Correlation between heat shock proteins, adiponectin, and T lymphocyte cytokine expression in type 2 diabetics. Cell Stress Chaperones 2018; 23:955-965. [PMID: 29752628 PMCID: PMC6111097 DOI: 10.1007/s12192-018-0903-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 04/03/2018] [Accepted: 04/19/2018] [Indexed: 01/30/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) features insulin resistance, hyperglycemia, dyslipidemia, overproduction of inflammatory cytokines, and systemic oxidative stress. Here, heat shock proteins Hsp70 and Hsp 90, adiponectin, and heme oxygenase-1 (HO-1, Hsp32) are profiled in peripheral blood mononuclear cells (PBMC) and serum from 25 T2DM patients and 25 healthy control subjects. Cells cultured with phorbol 12-myristate 13-acetate/ionomycin were evaluated by three-color flow cytometry for immunophenotypic biomarkers. Plasma HO-1, Hsp, and adiponectin levels were assayed by enzyme-linked immunosorbent assay (ELISA). Relative to healthy controls, T2DM patients exhibited significantly elevated plasma Hsp70, and representation of T helper immunophenotypes activated to express inflammatory cytokines, including CD4+ IFN-γ+, CD4+ TNF-α+, CD4+ IL-6+, CD4+ IL-1β+ T cells, significantly lower representation of CD4+ IL-10+ T cells, plasma adiponectin and cell-associated HO-1 expression-with no significant differences in plasma Hsp90 between T2DM and healthy controls. Plasma HO-1 and adiponectin in T2DM patients inversely correlated with TNF-α and showed inverse correlation between serum LDL and plasma HO-1. Moreover, TNF-α and Hsp90 in T2DM patients correlated positively with fasting blood glucose (FBG). These results demonstrate correlation between potentially pathogenic T cells, HO-1, and adiponectin, additionally revealing a T helper (Th)1-related character of T2DM immunopathogenesis, suggesting potential for novel T cell-related management strategies for T2DM and related co-morbidities.
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Affiliation(s)
- Fadia F Mahmoud
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait.
| | - David Haines
- Department of Epidemiology and Biostatistics, The George Washington University Medical Center, Washington, DC, USA
- Advanced Immune Biotherapeutics LLP, London, UK
| | - Ali A Dashti
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Sherief El-Shazly
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Fawzia Al-Najjar
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
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Hichami A, Grissa O, Mrizak I, Benammar C, Khan NA. Role of T-Cell Polarization and Inflammation and Their Modulation by n-3 Fatty Acids in Gestational Diabetes and Macrosomia. J Nutr Metab 2016; 2016:3124960. [PMID: 27313878 PMCID: PMC4897714 DOI: 10.1155/2016/3124960] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/10/2016] [Accepted: 05/05/2016] [Indexed: 01/04/2023] Open
Abstract
Th (T helper) cells are differentiated into either Th1 or Th2 phenotype. It is generally considered that Th1 phenotype is proinflammatory, whereas Th2 phenotype exerts anti-inflammatory or protective effects. Gestational diabetes mellitus (GDM) has been associated with a decreased Th1 phenotype, whereas macrosomia is marked with high expression of Th1 cytokines. Besides, these two pathological situations are marked with high concentrations of inflammatory mediators like tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), known to play a pivotal role in insulin resistance. Dietary n-3 polyunsaturated fatty acids (n-3 PUFAs) may exert a beneficial effect by shifting Th1/Th2 balance to a Th2 phenotype and increasing insulin sensitivity. In this paper, we shed light on the role of T-cell malfunction that leads to an inflammatory and pathophysiological state, related to insulin resistance in GDM and macrosomia. We will also discuss the nutritional management of these pathologies by dietary n-3 polyunsaturated fatty acids (PUFAs).
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Affiliation(s)
- A. Hichami
- INSERM U866, Université de Bourgogne, 21000 Dijon, France
| | - O. Grissa
- INSERM U866, Université de Bourgogne, 21000 Dijon, France
- Service de Physiologie et Explorations Fonctionnelles, Faculté de Médecine de Sousse, 4000 Sousse, Tunisia
| | - I. Mrizak
- INSERM U866, Université de Bourgogne, 21000 Dijon, France
- Service de Physiologie et Explorations Fonctionnelles, Faculté de Médecine de Sousse, 4000 Sousse, Tunisia
| | - C. Benammar
- INSERM U866, Université de Bourgogne, 21000 Dijon, France
- Laboratoire des Produits Naturels (LAPRONA), Département de Biologie Moléculaire et Cellulaire, Faculté des Sciences, Université Abou Bekr Belkaid, 25000 Tlemcen, Algeria
| | - N. A. Khan
- INSERM U866, Université de Bourgogne, 21000 Dijon, France
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How important is the butyrylcholinesterase level for cesarean section? Pregnancy Hypertens 2016; 6:26-9. [DOI: 10.1016/j.preghy.2016.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/19/2016] [Indexed: 12/14/2022]
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Guimarães LO, de Andrade FA, Bono GF, Setoguchi TE, Brandão MB, Chautard-Freire-Maia EA, Dos Santos ICR, Picheth G, Faria ACRDA, Réa RR, Souza RLR, Furtado-Alle L. Gestational diabetes mellitus (GDM) decreases butyrylcholinesterase (BChE) activity and changes its relationship with lipids. Genet Mol Biol 2013; 37:1-6. [PMID: 24688284 PMCID: PMC3958315 DOI: 10.1590/s1415-47572014000100003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 08/20/2013] [Indexed: 11/21/2022] Open
Abstract
Many conditions interfere with butyrylcholinesterase (BChE) activity, e.g., pregnancy or presence of the BCHE gene variant -116A can decrease activity whereas obesity and types I and II diabetes mellitus can increase activity. In this study, we examined BChE activity, -116A and 1615A BCHE gene variants, and anthropometric and biochemical variables associated with diabetes in patients with gestational diabetes mellitus (GDM) and in healthy pregnant women. BChE activity was measured spectrophotometrically using propionylthiocholine as substrate and genotyping of the -116 and 1615 sites of the BCHE gene was done with a TaqMan SNP genotyping assay. Three groups were studied: 150 patients with GDM, 295 healthy pregnant women and 156 non-pregnant healthy women. Mean BChE activity was significantly lower in healthy pregnant women than in women from the general population and was further reduced in GDM patients. BChE activity was significantly reduced in carriers of -116A in GDM patients and healthy pregnant women. Although GDM patients had a significantly higher mean body mass index (BMI) and triglycerides than healthy pregnant women, they had lower mean BChE activity, suggesting that the lowering effect of GDM on BChE activity was stronger than the characteristic enhancing effect of increased BMI and triglycerides.
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Affiliation(s)
- Larissa O Guimarães
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Fabiana A de Andrade
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Gleyse F Bono
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Thaís E Setoguchi
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Mariana B Brandão
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Eleidi A Chautard-Freire-Maia
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Izabella C R Dos Santos
- Laboratório de Bioquímica Clínica, Setor de Ciências da Saúde, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Geraldo Picheth
- Laboratório de Bioquímica Clínica, Setor de Ciências da Saúde, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Ana Cristina R de A Faria
- Unidade de Diabetes do Serviço de Endocrinologia e Metabolismo, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Rosângela R Réa
- Unidade de Diabetes do Serviço de Endocrinologia e Metabolismo, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Ricardo L R Souza
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Lupe Furtado-Alle
- Paboratório de Polimorfismos e Ligação, Departamento de Genética, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Sridhar GR, Rao AA, Srinivas K, Nirmala G, Lakshmi G, Suryanarayna D, Rao PVN, Kaladhar DGSVGL, Kumar SV, Devi TU, Nitesh T, Hanuman T. Butyrylcholinesterase in metabolic syndrome. Med Hypotheses 2010; 75:648-51. [PMID: 20797821 DOI: 10.1016/j.mehy.2010.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 08/01/2010] [Indexed: 01/21/2023]
Abstract
Butyrylcholinesterase may have a role in a number of metabolic functions and could affect the expression of insulin resistance syndrome. We present our integrated work using clinical, biochemical and bioinformatic approaches to delineate the possible function of this enzyme. Initially, we constructed a phylogenic tree with nucleotides and amino acid sequences and showed the existence of similar sequences in bacteria, plants and in other animals. We also demonstrated a possible pathogenic role for BChE in the common existence of insulin resistance, type 2 diabetes and Alzheimer's disease by in silico method and followed it up with a diabetic mouse study where cognition was slowed along with changes in BChE levels. In the next group of in silico studies, we employed THEMATICS method to identify the amino acids at the active site and later performed docking studies with drugs. THEMATICS predicted two clusters of ionisable amino acid residues that are in proximity: one with two residues and another with 11 showed perturbation in the THEMATICS curves. Using ISIS/Draw 2.5SP4, ARGUSLAB 4.0.1 and HEX 5.1. software. 3-D ligands were docked with BChE motif (from PDB). We did not find any of the ligands studied with significant docking distance, indicating they did not have direct interaction with the active site. Subsequently we performed in silico studies to compare the secondary structure and domain of BChE. Protein-protein interaction showed the following intersections with BChE UBE21, CHAT, APOE, AATF, DF ALDH9A1, PDHX, PONI PSME3 and ATP6VOA2. The integrative physiological roles of proteins with poorly known functions can be approached by generating leads in silico, which can be studied in vivo, setting into movement an iterative process.
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Affiliation(s)
- Gumpeny R Sridhar
- Endocrine and Diabetes Centre, 15-12-15 Krishananagar, Visakhapatnam 530 002, India.
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Omu AE, Al-Azemi MK, Omu FE, Fatinikun T, Abraham S, George S, Mahnazhath N. Butyrylcholinesterase activity in women with diabetes mellitus in pregnancy: Correlation with antioxidant activity. J OBSTET GYNAECOL 2010; 30:122-6. [DOI: 10.3109/01443610903443913] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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