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Kwon JY, Maeng YS. Human Cord Blood Endothelial Progenitor Cells and Pregnancy Complications (Preeclampsia, Gestational Diabetes Mellitus, and Fetal Growth Restriction). Int J Mol Sci 2024; 25:4444. [PMID: 38674031 PMCID: PMC11050478 DOI: 10.3390/ijms25084444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Hemangioblasts give rise to endothelial progenitor cells (EPCs), which also express the cell surface markers CD133 and c-kit. They may differentiate into the outgrowth endothelial cells (OECs) that control neovascularization in the developing embryo. According to numerous studies, reduced levels of EPCs in circulation have been linked to human cardiovascular disorders. Furthermore, preeclampsia and senescence have been linked to levels of EPCs produced from cord blood. Uncertainties surround how preeclampsia affects the way EPCs function. It is reasonable to speculate that preeclampsia may have an impact on the function of fetal EPCs during the in utero period; however, the present literature suggests that maternal vasculopathies, including preeclampsia, damage fetal circulation. Additionally, the differentiation potential and general activity of EPCs may serve as an indicator of the health of the fetal vascular system as they promote neovascularization and repair during pregnancy. Thus, the purpose of this review is to compare-through the assessment of their quantity, differentiation potency, angiogenic activity, and senescence-the angiogenic function of fetal EPCs obtained from cord blood for normal and pregnancy problems (preeclampsia, gestational diabetes mellitus, and fetal growth restriction). This will shed light on the relationship between the angiogenic function of fetal EPCs and pregnancy complications, which could have an effect on the management of long-term health issues like metabolic and cardiovascular disorders in offspring with abnormal vasculature development.
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Affiliation(s)
- Ja-Young Kwon
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University Health System, Seoul 03722, Republic of Korea;
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yong-Sun Maeng
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University Health System, Seoul 03722, Republic of Korea;
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 03722, Republic of Korea
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Diniz MS, Hiden U, Falcão-Pires I, Oliveira PJ, Sobrevia L, Pereira SP. Fetoplacental endothelial dysfunction in gestational diabetes mellitus and maternal obesity: A potential threat for programming cardiovascular disease. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166834. [PMID: 37541330 DOI: 10.1016/j.bbadis.2023.166834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Abstract
Gestational diabetes mellitus (GDM) and maternal obesity (MO) increase the risk of adverse fetal outcomes, and the incidence of cardiovascular disease later in life. Extensive research has been conducted to elucidate the underlying mechanisms by which GDM and MO program the offspring to disease. This review focuses on the role of fetoplacental endothelial dysfunction in programming the offspring for cardiovascular disease in GDM and MO pregnancies. We discuss how pre-existing maternal health conditions can lead to vascular dysfunction in the fetoplacental unit and the fetus. We also examine the role of fetoplacental endothelial dysfunction in impairing fetal cardiovascular system development and the involvement of nitric oxide and hydrogen sulfide in mediating fetoplacental vascular dysfunction. Furthermore, we suggest that the L-Arginine-Nitric Oxide and the Adenosine-L-Arginine-Nitric Oxide (ALANO) signaling pathways are pertinent targets for research. Despite significant progress in this area, there are still knowledge gaps that need to be addressed in future research.
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Affiliation(s)
- Mariana S Diniz
- CNC - Center for Neuroscience and Cell Biology, CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal; Ph.D. Programme in Experimental Biology and Biomedicine (PDBEB), Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
| | - Ursula Hiden
- Department of Obstetrics and Gynecology, Medical University of Graz, 8063 Graz, Austria; Research Unit Early Life Determinants (ELiD), Medical University of Graz, 8036 Graz, Austria
| | - Inês Falcão-Pires
- UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Paulo J Oliveira
- CNC - Center for Neuroscience and Cell Biology, CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrics, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain; Medical School (Faculty of Medicine), São Paulo State University (UNESP), São Paulo, Brazil; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Australia; Tecnologico de Monterrey, Eutra, The Institute for Obesity Research (IOR), School of Medicine and Health Sciences, Monterrey, Nuevo León, Mexico.
| | - Susana P Pereira
- CNC - Center for Neuroscience and Cell Biology, CIBB - Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal; Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal.
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Sultan S, AlMalki S. Analysis of global DNA methylation and epigenetic modifiers (DNMTs and HDACs) in human foetal endothelium exposed to gestational and type 2 diabetes. Epigenetics 2023; 18:2201714. [PMID: 37066707 PMCID: PMC10114969 DOI: 10.1080/15592294.2023.2201714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/16/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Foetuses exposed to maternal gestational diabetes (GDM) and type 2 diabetes (T2D) have an increased risk of adverse perinatal outcomes. Epigenetic mechanisms, including DNA methylation and histone modifications, may act as mediators of persistent metabolic memory in endothelial cells (ECs) exposed to hyperglycaemia, even after glucose normalization. Therefore, we investigated alterations in global DNA methylation and epigenetic modifier expression (DNMT1, DNMT3a, DNMT3b, HDAC1, and HDAC2) in human umbilical vein ECs (HUVECs) from the umbilical cords of mothers with GDM (n = 8) and T2D (n = 3) compared to that of healthy mothers (n = 6). Global DNA alteration was measured using a 5-methylation cytosine colorimetric assay, followed by quantitative real-time polymerase chain reaction to measure DNA methyltransferase and histone acetylase transcript expression. We revealed that DNA hypermethylation occurs in both GDM- and T2D-HUVECs compared to that in Control-HUVECs. Furthermore, there was a significant increase in HDAC2 mRNA levels in GDM-HUVECs and increase in DNMT3b mRNA levels in T2D-HUVECs. Overall, our results suggest that GDM and T2D are associated with global DNA hypermethylation in foetal endothelial cells under normoglycemic conditions and the aberrant mRNA expression of HDAC2 and DNMT3b could play a role in this dysregulation.
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Affiliation(s)
- Samar Sultan
- Medical Laboratory Sciences Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sultanh AlMalki
- Medical Laboratory Sciences Department, King Abdulaziz University, Jeddah, Saudi Arabia
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Fato BR, Beard S, Binder NK, Pritchard N, Kaitu’u-Lino TJ, de Alwis N, Hannan NJ. The Regulation of Endothelin-1 in Pregnancies Complicated by Gestational Diabetes: Uncovering the Vascular Effects of Insulin. Biomedicines 2023; 11:2660. [PMID: 37893034 PMCID: PMC10603897 DOI: 10.3390/biomedicines11102660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a condition of pregnancy defined by new-onset hyperglycemia. GDM is associated with impaired maternal endothelial and vascular reactivity. Endothelin-1 (ET-1) is a potent vasoconstrictor that contributes to endothelial dysfunction, however, its abundance and actions in GDM are unclear. Maternal plasma was obtained from pregnancies complicated by GDM (n = 24) and gestation-matched controls (n = 42); circulating ET-1 levels were assessed by ELISA. Human omental arteries from healthy pregnancies and those complicated by GDM were dissected from omental fat biopsies and collected at cesarean section. mRNA expression of ET-1 and its receptors, ETA and ETB, in addition to vascular cell adhesion molecule-1 (VCAM1) and intercellular adhesion molecule-1 (ICAM1) were assessed by qPCR (n = 28). Using wire myography, we investigated vascular constriction to ET-1 (10-11-10-4 M) in omental arteries from pregnancies complicated by GDM, compared to gestation-matched controls (n = 7). GDM cases were stratified by clinical management, diet intervention (n = 5), or insulin treatment (n = 6). Additionally, arteries from healthy pregnancies were treated with insulin (1 mU/mL (n = 7) and 10 mU/mL (n = 5)) or vehicle control. Vasoactive response to ET-1 was measured via wire myography. Circulating ET-1 levels and mRNA expression of the ET-1 system in omental arteries were not found to be significantly different between pregnancies complicated by GDM compared to healthy controls. However, we found insulin treatment during pregnancy and in ex vivo models reduced ET-1 vasoconstriction of maternal vasculature in GDM. These data suggest insulin may improve vascular function in GDM, however, further investigation is needed to define the role of ET-1 in pregnancy.
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Affiliation(s)
- Bianca R. Fato
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Sally Beard
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natalie K. Binder
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natasha Pritchard
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Tu’uhevaha J. Kaitu’u-Lino
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
- Diagnostic Discovery and Reverse Translation in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia
| | - Natasha de Alwis
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
| | - Natalie J. Hannan
- Therapeutics Discovery and Vascular Function in Pregnancy Group, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (B.R.F.); (S.B.); (N.K.B.); (N.d.A.)
- Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Heidelberg, VIC 3084, Australia; (N.P.); (T.J.K.-L.)
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Ristovska EC, Genadieva-Dimitrova M, Todorovska B, Milivojevic V, Rankovic I, Samardziski I, Bojadzioska M. The Role of Endothelial Dysfunction in the Pathogenesis of Pregnancy-Related Pathological Conditions: A Review. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2023; 44:113-137. [PMID: 37453122 DOI: 10.2478/prilozi-2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
In the recent decades, endothelial dysfunction (ED) has been recognized as a significant contributing factor in the pathogenesis of many pathological conditions. In interaction with atherosclerosis, hypercholesterolemia, and hypertension, ED plays a crucial role in the pathogenesis of coronary artery disease, chronic renal disease, and microvascular complications in diabetes mellitus. Although ED plays a significant role in the pathogenesis of several pregnancy-related disorders such as preeclampsia, HELLP syndrome, fetal growth restriction, and gestational diabetes mellitus, the exact pathogenetic mechanisms are still a matter of debate. The increased prevalence of these entities in patients with preexisting vascular diseases highlights the essential pathological role of the preexisting ED in these patients. The abnormal uteroplacental circulation and the release of soluble factors from the ischemic placenta into the maternal bloodstream are the main causes of the maternal ED underlying the characteristic preeclamptic phenotype. Besides the increased risk for maternal and fetal poor outcomes, the preexisting ED also increases the risk of development of future cardiovascular diseases in these patients. This study aimed to look deeper into the role of ED in the pathogenesis of several pregnancy-related hypertensive and liver diseases. Hopefully, it could contribute to improvement of the awareness, knowledge, and management of these conditions and also to the reduction of the adverse outcomes and additional long-term cardiovascular complications.
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Affiliation(s)
- Elena Curakova Ristovska
- 1University Clinic for Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia
| | - Magdalena Genadieva-Dimitrova
- 1University Clinic for Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia
| | - Beti Todorovska
- 1University Clinic for Gastroenterohepatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia
| | - Vladimir Milivojevic
- 2Section for Internal Medicine, Medcompass Alliance, School of Medicine, Belgrade University, Belgrade, Serbia
| | - Ivan Rankovic
- 3Section for Internal Medicine, Medcompass Alliance, Belgrade, Serbia
| | - Igor Samardziski
- 4University Clinic for Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia
| | - Maja Bojadzioska
- 5University Clinic for Rheumatology, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, RN Macedonia
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Del Mar Roca-Rodríguez M, Ramos-García P, López-Tinoco C, Aguilar-Diosdado M. Significance of cell adhesion molecules profile during pregnancy in gestational diabetes mellitus. A systematic review and meta-analysis. Diabetes Res Clin Pract 2023:110740. [PMID: 37276983 DOI: 10.1016/j.diabres.2023.110740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
Endothelial dysfunction has been considered as a key etiological factor contributed to the development of vascular disease in diabetes mellitus. Serum level of endothelial cell adhesion molecules (AMs) were reported to be increased in GDM and pregnant women with normal glucose tolerance when compared with nonpregnant women. The literature provides limited evidence of endothelial dysfunction in GDM with heterogeneous and contradictory results respect to their possible involvement in maternal, perinatal and future complications. Our objective is to evaluate current evidence on the role of AMs in maternal and perinatal complications in women with GDM. PubMed, Embase, Web of Science, and Scopus databases were searched. We evaluated the studies' quality using the Newcastle-Ottawa scale. Meta-analyses were conducted, and heterogeneity and publication bias were examined. Nineteen relevant studies were finally included, recruiting 765 GDM and 2368 control pregnant women. AMs levels were generally higher in GDM participants showing statistical significance maternal ICAM-1 levels (SMD=0.58, 95% CI= 0.25 to 0.91; p=0.001). Our meta-analysis did not detect significant differences in subgroups or in meta-regression analyses. Future studies are needed to establish the potential role of these biomarkers in GDM and its complications.
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Affiliation(s)
- María Del Mar Roca-Rodríguez
- Department of Endocrinology and Nutrition and Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain
| | - Pablo Ramos-García
- Department of Oral Medicine, School of Dentistry, University of Granada, 18071 Granada, Spain.
| | - Cristina López-Tinoco
- Department of Endocrinology and Nutrition and Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; Department of Medicine, Cadiz University (UCA), 11003 Cadiz, Spain.
| | - Manuel Aguilar-Diosdado
- Department of Endocrinology and Nutrition and Biomedical Research and Innovation Institute of Cadiz (INiBICA), Puerta del Mar University Hospital, 11009 Cadiz, Spain; Department of Medicine, Cadiz University (UCA), 11003 Cadiz, Spain.
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Akbari H, Monemi F, Notej A, Khajavi A, Asadi Ghadikolaei O, Abdolmaleki F, Najafi L. Hs-CRP and TNF-α Effects on Postnatal Umbilical Coiling: Impact Assessment of the Gestational Diabetes Mellitus. Med J Islam Repub Iran 2023; 37:56. [PMID: 37457424 PMCID: PMC10349364 DOI: 10.47176/mjiri.37.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Indexed: 07/18/2023] Open
Abstract
Background No study has been conducted to specifically demonstrate the relationship between gestational diabetes mellitus (GDM) status, inflammatory factors, and postnatal umbilical coiling index (pUCI). Understanding this relationship could help select the best interventions to save the fetus. To evaluate the effects of maternal venous and umbilical cord blood levels of high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) on pUCI in GDM and non-GDM groups. Methods This prospective observational study included 40 participants in each of the GDM and non-GDM groups, matched for maternal age, ethnicity, and parity. The GDM diagnosis was confirmed by 24 to 28 weeks of gestation (WOG) and a 2-step strategy. The covariates of interest were maternal hs-CRP and TNF-α, measured at 37 to 40 WOG, and their UC analogous was measured during delivery. The gross morphologies were assessed immediately after delivery. The UC coiling was quantitatively assessed by the pUCI. To compare the GDM and non-GDM groups, the t test and the Mann-Whitney test were used for normal and non-normal variables, respectively. Results There was not a significant difference in hs-CRP and TNF-a levels in maternal venous blood or UC blood between the GDM and non-GDM groups. The mean (SD) of pUCI in the GDM and non-GDM groups were 0.28 (0.15) and 0.24 (0.21) (P = 0.441), respectively. In the GDM group, none of the 4 covariates of interest had significant effects on the UCI. Among the non-GDM participants, merely the UC hs-CRP had a direct association with the pUCI, with a Pearson correlation of 0.54 (P = 0.001). Impacts of hs-CRP and TNF-α on the pUCI were assessed using Poisson regression models and no significant findings were detected (95% CI, 0.999-1.001, for all parameters). Conclusion In the GDM group, no apparent association was observed between inflammatory factors and pUCI, although a direct association was detected between UC hs-CRP and pUCI in the non-GDM.
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Affiliation(s)
- Hamideh Akbari
- Clinical Research Development Center, Sayad Shirazi Hospital, Golestan
University of Medical Sciences, Gorgan, Iran
| | - Fateme Monemi
- Clinical Research Development Center, Sayad Shirazi Hospital, Golestan
University of Medical Sciences, Gorgan, Iran
| | - Atefe Notej
- Clinical Research Development Center, Sayad Shirazi Hospital, Golestan
University of Medical Sciences, Gorgan, Iran
| | - Alireza Khajavi
- Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti
University of Medical Sciences, Tehran, Iran
| | - Omolbanin Asadi Ghadikolaei
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran
University of Medical Sciences, Tehran, Iran
| | - Fereshte Abdolmaleki
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran
University of Medical Sciences, Tehran, Iran
| | - Laily Najafi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran
University of Medical Sciences, Tehran, Iran
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Di Martino DD, Soldavini CM, Rossi G, Lonardoni MC, Tinè G, Caneschi A, D’Ambrosi F, Ferrazzi E. The sFlt-1/PlGF Ratio in Patients Affected by Gestational Diabetes and SARS-CoV-2 Infection. Metabolites 2022; 13:metabo13010054. [PMID: 36676978 PMCID: PMC9866868 DOI: 10.3390/metabo13010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Low values of the ratio of plasmatic soluble blocking factor FMS-like tyrosine Kinase 1 and placental growth factor (sFlt-1/PlGF) are required for an adequate placental angiogenesis and function. It has been shown that patients affected by gestational diabetes (GD) and patients with pneumonia from SARS-CoV-2 are characterized by an increased sFlt-1/PlGF ratio. The aim of the present study was to evaluate the sFlt-1-PlGF ratio in pregnancies complicated by COVID-19 and GD. We compared the plasmatic sFlt-1/PlGF ratio among the following groups of pregnant women: COVID-19, GD patients; COVID-19, non-GD patients; non-COVID-19, GD patients; and non-COVID-19, non-GD controls. We enrolled 62 women in the present study, who were divided as follows: 14 COVID-19, GD patients; 12 COVID-19, non-GD patients; 11 non-COVID-19, GD patients; and 25 non-COVID-19, non-GD controls. The COVID-19, GD patients presented a higher pre-pregnancy BMI, a higher prevalence of hypertensive disorders of pregnancy as a co-morbidity, and an increased need for medication for their diabetes. Neonatal data were similar between the groups. The controls showed a significantly lower sFlt-1/PlGF ratio compared to pregnancies complicated by GD and SARS-CoV-2 infection. The sFlt-1/PlGF ratio was higher in patients affected by both GD and SARS-CoV-2 infection; these subjects were characterized by a greater incidence of obesity and hypertensive disorders of pregnancy.
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Affiliation(s)
- Daniela Denis Di Martino
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence:
| | - Chiara Maria Soldavini
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gabriele Rossi
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Maria Chiara Lonardoni
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Gabriele Tinè
- Department of Economics and Quantitative Methods, University of Milano Bicocca, 20900 Monza, Italy
| | - Agnese Caneschi
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Francesco D’Ambrosi
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Enrico Ferrazzi
- Obstetrics Unit, Department of Woman Child and Newborn, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical and Community Sciences, University of Milan, 20122 Milan, Italy
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Sawangpanyangkura T, Laohapand P, Boriboonhirunsarn D, Boriboonhirunsarn C, Bunpeng N, Tansriratanawong K. Upregulation of microRNA-223 expression in gingival crevicular blood of women with gestational diabetes mellitus and periodontitis. J Dent Sci 2022; 17:863-869. [PMID: 35756772 PMCID: PMC9201537 DOI: 10.1016/j.jds.2021.09.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
Background/Purpose MicroRNA-223 (miR-223) is involved in several inflammatory diseases, including gestational diabetes mellitus (GDM) and periodontitis. We first described a procedure for purifying miR-223 from gingival crevicular blood (GCB) of pregnant women with or without GDM and periodontitis. This study aimed to determine whether GDM and/or periodontitis modifies miR-223 expression in pregnant women and to analyze miR-223-targeted messenger RNA (mRNA) expression levels in GCB compared to peripheral blood (PB). Materials and methods Pregnant women were allocated to 4 groups: 10 women with GDM and periodontitis (GDM/P), 10 women with GDM without periodontitis (GDM/NP), 9 women with periodontitis and without GDM (NGDM/P) and 10 women without either condition (NGDM/NP). Clinical parameters of GDM and periodontal status were examined. GCB and PB were collected to assess miR-223, ICAM-1, IL-1β and β1-integrin gene expression by quantitative real-time polymerase chain reaction. Results The GDM/P group demonstrated the highest miR-223 expression levels among the 4 groups in GCB. A significant difference was found between GDM/P and GDM/NP group (P = 0.04). In contrast, the GDM/P showed the lowest miR-223 expression level in PB among the 4 groups. Moreover, ICAM-1 and IL-1β mRNA expression exhibited the opposite trend of miRNA-223, indicating that miRNA-223 might regulate the mRNA function of those genes by epigenetic events. Conclusion The upregulation of miR-223 expression in GCB but downregulation in PB, ICAM-1 and IL-1β genes expression in women with GDM and periodontitis suggest a promising role of miR-223 in the association between GDM and periodontitis.
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Affiliation(s)
- Teerat Sawangpanyangkura
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Penpan Laohapand
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Dittakarn Boriboonhirunsarn
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Nattawan Bunpeng
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallapat Tansriratanawong
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- Corresponding author. Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, 10400. Thailand.
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Angiogenic Imbalance and Inflammatory Biomarkers in the Prediction of Hypertension as Well as Obstetric and Perinatal Complications in Women with Gestational Diabetes Mellitus. J Clin Med 2022; 11:jcm11061514. [PMID: 35329840 PMCID: PMC8953606 DOI: 10.3390/jcm11061514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/26/2022] [Accepted: 03/08/2022] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) increases the risk of hypertensive disorders of pregnancy (HDP). We aimed to analyze the altered inflammatory markers and angiogenic factors among women with GDM to identify pregnant women at higher risk of developing HDP. Methods: This was a prospective study of 149 women without hypertension diagnosed in the third trimester with GDM. Inflammatory markers and angiogenic factors were measured at 28−32 weeks of pregnancy. Obstetric and perinatal outcomes were evaluated. Results: More than eight percent of the women developed HDP. Higher levels of the soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PIGF) ratio (4.9 ± 2.6 versus 2.3 ± 1.3, respectively; p < 0.001) and leptin (10.9 ± 0.8 versus 10.08 ± 1.1, respectively; p = 0.038), as well as lower levels of adiponectin (10.5 ± 1.3 versus 12.9 ± 2.7, respectively; p = 0.031), were seen in women who developed HDP versus normotensive women with GDM. A multivariable logistic regression analysis showed that adiponectin had a protective effect with 0.45-fold odds (0.23−0.83; p = 0.012), and that the sFlt-1/PIGF ratio was associated with 2.70-fold odds of developing HDP (CI 95%: 1.24−5.86; p = 0.012). Conclusion: An increase in angiogenic imbalance in the sFlt-1/PIGF ratio in women with GDM was detected and may be an indicator of developing HDP in addition to any subsequent obstetric and perinatal complications.
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11
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A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease. Reprod Sci 2022; 30:81-92. [PMID: 35257355 PMCID: PMC9810675 DOI: 10.1007/s43032-022-00904-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/25/2022] [Indexed: 01/07/2023]
Abstract
Obstructive sleep apnea (OSA) usually leads to the occurrence of diabetes. Gestational diabetes mellitus (GDM) is a common gestational complication associated with adverse maternal and fetal outcomes. Increasing studies suggest that women with OSA during pregnancy may be at a significantly greater risk of developing GDM. It is crucial to explore the association between OSA and GDM and the mechanisms underlying this association. In this review, we presented a comprehensive literature review of the following: the association between OSA and GDM, the possible mechanisms of this association, and the effects of continuous positive airway pressure (CPAP) on OSA with GDM. The results showed that most authors suggested that there was an association between OSA and GDM. The intermittent hypoxemia (IH) and reduction of slow-wave sleep (SWS) may be the key to this association. IH induces the products of oxidative stress and inflammation as well as dysregulation of the hypothalamic-pituitary-adrenal, which lead to diabetes. In addition, SWS reduction in OSA enhances the inflammation by increasing the inflammatory cytokines, increases the sympathetic activation, and causes changes in leptin level, which result in the development of GDM. Additionally, whether CPAP is beneficial to GDM remains still unclear.
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12
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Kornacki J, Gutaj P, Kalantarova A, Sibiak R, Jankowski M, Wender-Ozegowska E. Endothelial Dysfunction in Pregnancy Complications. Biomedicines 2021; 9:1756. [PMID: 34944571 PMCID: PMC8698592 DOI: 10.3390/biomedicines9121756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022] Open
Abstract
The endothelium, which constitutes the inner layer of blood vessels and lymphatic structures, plays an important role in various physiological functions. Alterations in structure, integrity and function of the endothelial layer during pregnancy have been associated with numerous gestational complications, including clinically significant disorders, such as preeclampsia, fetal growth restriction, and diabetes. While numerous experimental studies have focused on establishing the role of endothelial dysfunction in pathophysiology of these gestational complications, their mechanisms remain unknown. Numerous biomarkers of endothelial dysfunction have been proposed, together with the mechanisms by which they relate to individual gestational complications. However, more studies are required to determine clinically relevant markers specific to a gestational complication of interest, as currently most of them present a significant overlap. Although the independent diagnostic value of such markers remains to be insufficient for implementation in standard clinical practice at the moment, inclusion of certain markers in predictive multifactorial models can improve their prognostic value. The future of the research in this field lies in the fine tuning of the clinical markers to be used, as well as identifying possible therapeutic techniques to prevent or reverse endothelial damage.
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Affiliation(s)
- Jakub Kornacki
- Department of Reproduction, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; (J.K.); (E.W.-O.)
| | - Paweł Gutaj
- Department of Reproduction, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; (J.K.); (E.W.-O.)
| | - Anastasia Kalantarova
- Medicine Program, Poznan University of Medical Sciences, 41 Jackowskiego Street, 60-512 Poznan, Poland;
| | - Rafał Sibiak
- Department of Histology and Embryology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland;
| | - Maurycy Jankowski
- Department of Anatomy, Poznan University of Medical Sciences, 6 Swiecickiego Street, 60-781 Poznan, Poland;
| | - Ewa Wender-Ozegowska
- Department of Reproduction, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland; (J.K.); (E.W.-O.)
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13
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Contreras-Duarte S, Claudette C, Farias M, Leiva A. High total cholesterol and triglycerides levels increase arginases metabolism, impairing nitric oxide signaling and worsening fetoplacental endothelial dysfunction in gestational diabetes mellitus pregnancies. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166216. [PMID: 34314821 DOI: 10.1016/j.bbadis.2021.166216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022]
Abstract
During human pregnancy, maternal physiological dyslipidemia (MPD) supports fetal development. However, some women develop maternal supraphysiological dyslipidemia (MSPD: increased total cholesterol (TC) and triglycerides (TG) levels). MSPD is present in normal and pregnancies with gestational diabetes mellitus (GDM). Both pathologies associate with fetoplacental endothelial dysfunction, producing alterations in nitric oxide (NO)-L-arginine/arginase metabolism. Nevertheless, the effect of MSPD on GDM, and how this synergy alters fetoplacental endothelial function is unknown, which is the aim of this study. 123 women at term of pregnancy were classified as MPD (n=40), MSPD (n=35), GDM with normal lipids (GDM- MPD, n=23) and with increased lipids (GDM-MSPD, n=25). TC ≥291 mg/dL and TG ≥275 mg/dL were considered as MSPD. Endothelial NO synthase (eNOS), human cationic amino acid transporter 1 (hCat1), and arginase II protein abundance and activity, were assayed in umbilical vein endothelial cells. In MSPD and MSPD-GDM, TC and TG increased respect to MPD and MPD-GDM. eNOS activity was reduced in MSPD and MSPD-GDM, but increased in MPD-GDM compared with MPD. No changes were observed in eNOS protein. However, decreased tetrahydrobiopterin levels were observed in all groups compared with MPD. Increased hCat1 protein and L-arginine transport were observed in both GDM groups compared with MPD. However, the transport was higher in GDM-MSPD compared to GDM-MPD. Higher Arginase II protein and activity were observed in MSPD-GDM compared with MPD. Thus, MSPD in GDM pregnancies alters fetal endothelial function associated with NO metabolism.
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Affiliation(s)
- S Contreras-Duarte
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile.
| | - C Claudette
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile
| | - M Farias
- School of Medical Technology, Health Sciences Faculty, Universidad San Sebastian, Santiago 7510156, Chile
| | - A Leiva
- Department of Obstetrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
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14
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Markopoulou P, Papanikolaou E, Loukopoulou S, Galina P, Mantzou A, Siahanidou T. Increased circulating endothelial progenitor cells (EPCs) in prepubertal children born prematurely: a possible link between prematurity and cardiovascular risk. Pediatr Res 2021; 90:156-165. [PMID: 33038874 DOI: 10.1038/s41390-020-01190-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/17/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endothelial progenitor cells (EPCs) ensure vascular integrity and neovascularization. No studies have investigated EPCs in preterm-born children beyond infancy. METHODS One hundred and thirty-six prepubertal children were enrolled: 63 preterm and 73 born at term (controls). Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were measured in preterm-born children compared to controls. Body mass index (BMI), waist-to-hip ratio (WHR), neck circumference, systolic and diastolic blood pressure (SBP and DBP, respectively), fasting glucose, insulin, lipid profile, common carotid and abdominal aortic intima-media thickness (cIMT and aIMT, respectively), endothelium-dependent brachial artery flow-mediated dilation (FMD), and echocardiographic parameters were also assessed. RESULTS Circulating CD34(+)/VEGFR-2(+)/CD45(-) and CD34(+)/VEGFR-2(+)/CD45dim EPCs were significantly higher in preterm-born children compared to controls (p < 0.001 and p < 0.001, respectively). In total study population and in the preterm-born group, EPCs were significantly lower in children born to mothers with gestational diabetes compared to non-diabetic mothers. Prematurity was associated with higher WHR, neck circumference, SBP, DBP, cIMT, aIMT, mean pressure, and velocity of pulmonary artery; the peak velocity of the brachial artery was significantly lower in children born prematurely. In multiple regression analysis, preterm birth and maternal gestational diabetes were recognized as independent predictors of EPCs. CONCLUSIONS Circulating EPCs were increased in prepubertal preterm-born children in comparison with peers born full-term. Maternal gestational diabetes was associated with a decrease in EPCs. IMPACT Mounting evidence supports the adverse effect of prematurity on cardiovascular health. However, the underlying mechanisms that could lead to endothelial dysfunction in preterm-born individuals are not fully understood. Endothelial progenitor cells (EPCs) ensure vascular integrity, normal endothelial function and neovascularization. No studies have investigated the EPCs counts in peripheral blood beyond infancy in children born prematurely. Circulating EPCs were significantly higher in preterm-born prepubertal children compared to controls, thus indicating that prematurity is possibly associated with endothelial damage. In total study population and in the preterm-born group, maternal gestational diabetes was associated with decreased EPCs concentrations.
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Affiliation(s)
- Panagiota Markopoulou
- Neonatal Unit, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Papanikolaou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Loukopoulou
- Department of Cardiology, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Paraskevi Galina
- Radiology Department, "Agia Sofia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Tania Siahanidou
- Neonatal Unit, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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15
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Stadler JT, Wadsack C, Marsche G. Fetal High-Density Lipoproteins: Current Knowledge on Particle Metabolism, Composition and Function in Health and Disease. Biomedicines 2021; 9:biomedicines9040349. [PMID: 33808220 PMCID: PMC8067099 DOI: 10.3390/biomedicines9040349] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/20/2022] Open
Abstract
Cholesterol and other lipids carried by lipoproteins play an indispensable role in fetal development. Recent evidence suggests that maternally derived high-density lipoprotein (HDL) differs from fetal HDL with respect to its proteome, size, and function. Compared to the HDL of adults, fetal HDL is the major carrier of cholesterol and has a unique composition that implies other physiological functions. Fetal HDL is enriched in apolipoprotein E, which binds with high affinity to the low-density lipoprotein receptor. Thus, it appears that a primary function of fetal HDL is the transport of cholesterol to tissues as is accomplished by low-density lipoproteins in adults. The fetal HDL-associated bioactive sphingolipid sphingosine-1-phosphate shows strong vasoprotective effects at the fetoplacental vasculature. Moreover, lipoprotein-associated phospholipase A2 carried by fetal-HDL exerts anti-oxidative and athero-protective functions on the fetoplacental endothelium. Notably, the mass and activity of HDL-associated paraoxonase 1 are about 5-fold lower in the fetus, accompanied by an attenuation of anti-oxidative activity of fetal HDL. Cholesteryl ester transfer protein activity is reduced in fetal circulation despite similar amounts of the enzyme in maternal and fetal serum. This review summarizes the current knowledge on fetal HDL as a potential vasoprotective lipoprotein during fetal development. We also provide an overview of whether and how the protective functionalities of HDL are impaired in pregnancy-related syndromes such as pre-eclampsia or gestational diabetes mellitus.
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Affiliation(s)
- Julia T. Stadler
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
- Correspondence: (J.T.S.); (G.M.); Tel.: +43-316-385-74115 (J.T.S.); +43-316-385-74128 (G.M.)
| | - Christian Wadsack
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria;
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria
- Correspondence: (J.T.S.); (G.M.); Tel.: +43-316-385-74115 (J.T.S.); +43-316-385-74128 (G.M.)
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16
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Burlina S, Dalfrà MG, Lapolla A. Long-term cardio-metabolic effects after gestational diabetes: a review. J Matern Fetal Neonatal Med 2021; 35:6021-6028. [PMID: 33779467 DOI: 10.1080/14767058.2021.1903863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Women with GDM are at high risk of metabolic syndrome and type 2 diabetes (T2DM). A relationship with GDM and future development of cardiovascular disease (CVD) has been also recognized. Pregnancy and postpartum period in women with GDM give us the opportunity to identify the underlying, often unrecognized, CVD risk factors. Ideally, the postpartum follow-up of this women should be done by a multidisciplinary team to evaluate their cardio-metabolic risk and to counseling regarding lifestyle modification (healthy diet and regular physical activity) and breastfeeding that can reduce their risk. Longer follow-up of these women should be individualized, focusing attention on women at medium-high cardio-metabolic risk. The link between GDM and T2DM-CVD offers us a great opportunity for the diseases prevention.
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Affiliation(s)
- S Burlina
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - M G Dalfrà
- Department of Medicine - DIMED, University of Padova, Padova, Italy
| | - A Lapolla
- Department of Medicine - DIMED, University of Padova, Padova, Italy
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17
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Chen Y, Huang D, Liu J, Zeng F, Tang G, Lei W, Wang H, Jiang Y, Shentu W, Wang H. Non-Invasive Detection of Fetal Vascular Endothelial Function in Gestational Diabetes Mellitus. Front Endocrinol (Lausanne) 2021; 12:763683. [PMID: 34777257 PMCID: PMC8586207 DOI: 10.3389/fendo.2021.763683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/07/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Endothelial dysfunction in the fetuses of women with gestational diabetes mellitus (GDM) is associated with their subsequent cardiovascular events. Prenatal assessment of endothelial function in fetuses exposed to intrauterine hyperglycemic environment remains challenging. The aim of this study was to assess the fetal vascular endothelial function in GDM patients using color M-mode derived aortic propagation velocity (APV) and evaluate the correlation of APV with endothelial function biomarkers. METHODS This observational cross-sectional study included 31 gestational diabetic mothers and 30 healthy pregnant mothers from August 2019 to January 2020. Clinical data were compared between the groups. Fetal APV was measured using color M-mode echocardiography at late gestation. Concentrations of endothelial biomarkers including von Willebrand Factor (vWF), vascular endothelial-cadherin and endothelin-1 in umbilical cord serum were assessed. Measurements between diabetic group and controls were compared. RESULTS vWF was the only endothelial functional marker that differed between the two groups. Fetuses in the GDM group had significantly lower APV levels and higher vWF levels compared with the healthy controls (P < 0.05). There was a moderate but significant correlation between APV and vWF (r =-0.58, P < 0.001). There were no associations between APV and ventricular wall thickness or umbilical artery pulsatility index. CONCLUSIONS Color M-mode propagation velocity of aorta is a non-invasive, practical method that correlates well with GDM and fetal endothelial function. This novel metric could contribute to recognizing early vascular functional alterations and hence represents a potential strategy for early risk factor surveillance and risk modification.
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Affiliation(s)
- Yunyu Chen
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Danping Huang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jinrong Liu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Fangling Zeng
- Institute of Perinatal Nutrition, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Guoyi Tang
- Institute of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wenjia Lei
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Haiyu Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanmin Jiang
- Institute of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Weihui Shentu
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Weihui Shentu, ; Hongying Wang,
| | - Hongying Wang
- Department of Medical Ultrasonics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Weihui Shentu, ; Hongying Wang,
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18
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McElwain CJ, Tuboly E, McCarthy FP, McCarthy CM. Mechanisms of Endothelial Dysfunction in Pre-eclampsia and Gestational Diabetes Mellitus: Windows Into Future Cardiometabolic Health? Front Endocrinol (Lausanne) 2020; 11:655. [PMID: 33042016 PMCID: PMC7516342 DOI: 10.3389/fendo.2020.00655] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/11/2020] [Indexed: 12/12/2022] Open
Abstract
Placental insufficiency and adipose tissue dysregulation are postulated to play key roles in the pathophysiology of both pre-eclampsia (PE) and gestational diabetes mellitus (GDM). A dysfunctional release of deleterious signaling motifs can offset an increase in circulating oxidative stressors, pro-inflammatory factors and various cytokines. It has been previously postulated that endothelial dysfunction, instigated by signaling from endocrine organs such as the placenta and adipose tissue, may be a key mediator of the vasculopathy that is evident in both adverse obstetric complications. These signaling pathways also have significant effects on long term maternal cardiometabolic health outcomes, specifically cardiovascular disease, hypertension, and type II diabetes. Recent studies have noted that both PE and GDM are strongly associated with lower maternal flow-mediated dilation, however the exact pathways which link endothelial dysfunction to clinical outcomes in these complications remains in question. The current diagnostic regimen for both PE and GDM lacks specificity and consistency in relation to clinical guidelines. Furthermore, current therapeutic options rely largely on clinical symptom control such as antihypertensives and insulin therapy, rather than that of early intervention or prophylaxis. A better understanding of the pathogenic origin of these obstetric complications will allow for more targeted therapeutic interventions. In this review we will explore the complex signaling relationship between the placenta and adipose tissue in PE and GDM and investigate how these intricate pathways affect maternal endothelial function and, hence, play a role in acute pathophysiology and the development of future chronic maternal health outcomes.
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Affiliation(s)
- Colm J. McElwain
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
- *Correspondence: Colm J. McElwain
| | - Eszter Tuboly
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
| | - Fergus P. McCarthy
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Cathal M. McCarthy
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork, Ireland
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19
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Majcher S, Ustianowski P, Tarnowski M, Dziedziejko V, Safranow K, Pawlik A. IL-1β and IL-10 gene polymorphisms in women with gestational diabetes. J Matern Fetal Neonatal Med 2019; 34:3169-3174. [PMID: 31630588 DOI: 10.1080/14767058.2019.1678141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIMS Gestational diabetes (GDM) is carbohydrate intolerance occurring in pregnant women. In the GDM pathogenesis, the low-grade inflammation plays a significant role. Various inflammatory mediators are considered to be risk factors leading to GDM development including cytokines. Studies suggest that some cytokines such as: IL-1β and IL-10 play an important role in GDM pathogenesis. The aim of the study was to examine the associations between IL-1β rs16944, and IL-10 rs1800872 gene polymorphisms and GDM. METHODS This study included 204 pregnant women with GDM and 207 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75-g oral glucose tolerance test administered at 24-28 weeks' gestation. Among the pregnant women with GDM, 152 (75%) were treated with diet control alone throughout the pregnancy, whereas the remaining 52 (25%) were treated with diet control and insulin until delivery. RESULTS There were no statistically significant differences in the distribution of IL-1β rs16944 and IL-10 rs1800872 between GDM and healthy women. However among women treated with insulin, we observed the increased frequency of IL-1β rs16944 AA genotype carriers. Additionally, we observed increased daily insulin requirement in women with IL-1β rs16944 AA genotype. Moreover, women with IL-10 rs1800872 AA genotype had higher body mass and BMI before pregnancy as well as higher body mass and BMI increase during pregnancy. CONCLUSIONS The results of our study suggest the association between IL-1β rs16944 AA genotype and increased frequency of the need of insulin treatment as well as increased daily insulin requirement.
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Affiliation(s)
- Sandra Majcher
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Przemysław Ustianowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
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20
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Siddiqui K, George TP, Nawaz SS, Joy SS. VCAM-1, ICAM-1 and selectins in gestational diabetes mellitus and the risk for vascular disorders. Future Cardiol 2019; 15:339-346. [PMID: 31385530 DOI: 10.2217/fca-2018-0042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Aim: Levels of VCAM-1, ICAM-1 and selectins in gestational diabetes mellitus (GDM) subjects are an indication of endothelial dysfunction predicting the future metabolic consequence via metabolic memory effect. Materials & methods: This cross-sectional study was conducted in 92 pregnant women and serum endothelial cell adhesion molecules were measured using Randox biochip analyzer. Results: Significantly elevated serum level of VCAM-1 was found in GDM subjects and in greater than equal to one parity categorized GDM group when compared with control. The correlation of parity and P-selectin was statistically significant in GDM subjects. Conclusion: Elevated levels of endothelial cell adhesion molecules in GDM women indicate an imbalance in vascular function. Transient hyperglycemia during pregnancy may induce persistent modifications to the memory cells and GDM subjects are more prone to develop future consequences.
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Affiliation(s)
- Khalid Siddiqui
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia
| | - Teena P George
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia
| | - Shaik Sarfaraz Nawaz
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia
| | - Salini Scaria Joy
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia
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21
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Il'yasova D, Kinev A, Grégoire R, Beeson CC. A Cell-Based Approach to Study the Associations Between Mitochondrial Health, Early Life Exposures, and Consequent Health Outcomes. Front Public Health 2019; 7:36. [PMID: 30918888 PMCID: PMC6424859 DOI: 10.3389/fpubh.2019.00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/12/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dora Il'yasova
- Department of Population Health Science, School of Public Health, Georgia State University, Atlanta, GA, United States
| | | | - Rose Grégoire
- Department of Population Health Science, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Craig C Beeson
- Department of Pharmaceutical and Biomedical Sciences, Medical University of South Carolina, Charleston, SC, United States
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22
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Echeverria C, Eltit F, Santibanez JF, Gatica S, Cabello-Verrugio C, Simon F. Endothelial dysfunction in pregnancy metabolic disorders. Biochim Biophys Acta Mol Basis Dis 2019; 1866:165414. [PMID: 30794867 DOI: 10.1016/j.bbadis.2019.02.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 12/19/2022]
Abstract
In recent years, the vascular endothelium has gained attention as a key player in the initiation and development of pregnancy disorders. Endothelium acts as an endocrine organ that preserves the homeostatic balance by responding to changes in metabolic status. However, in metabolic disorders, endothelial cells adopt a dysfunctional function, losing their normal responsiveness. During pregnancy, several metabolic changes occur, in which endothelial function decisively participates. Similarly, when pregnancy metabolic disorders occur, endothelial dysfunction plays a key role in pathogenesis. This review outlines the main findings regarding endothelial dysfunction in three main metabolic pathological conditions observed during pregnancy: gestational diabetes, hypertensive disorders, and obesity and hyperlipidemia. Organ, histological and cellular characteristics were thoroughly described. Also, we focused in discussing the underlying molecular mechanisms involved in the cellular signaling pathways that mediate responses in these pathological conditions.
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Affiliation(s)
- Cesar Echeverria
- Facultad de Medicina, Universidad de Atacama, Copayapu 485, 1531772 Copiapo, Chile
| | - Felipe Eltit
- Department of Materials Engineering, University of British Columbia, Vancouver, Canada; School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Juan F Santibanez
- Department of Molecular Oncology, Institute for Medical Research, University of Belgrade, Belgrade, Serbia; Centro Integrativo de Biología y Química Aplicada (CIBQA), Universidad Bernardo O'Higgins, Santiago, Chile
| | - Sebastian Gatica
- Departamento de Ciencias Biologicas, Facultad de Ciencias de la Vida, Universidad Andres Bello, 8370146 Santiago, Chile; Millennium Institute on Immunology and Immunotherapy, 8331150 Santiago, Chile
| | - Claudio Cabello-Verrugio
- Departamento de Ciencias Biologicas, Facultad de Ciencias de la Vida, Universidad Andres Bello, 8370146 Santiago, Chile; Millennium Institute on Immunology and Immunotherapy, 8331150 Santiago, Chile; Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - Felipe Simon
- Departamento de Ciencias Biologicas, Facultad de Ciencias de la Vida, Universidad Andres Bello, 8370146 Santiago, Chile; Millennium Institute on Immunology and Immunotherapy, 8331150 Santiago, Chile.
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Diabetic endothelial colony forming cells have the potential for restoration with glycomimetics. Sci Rep 2019; 9:2309. [PMID: 30783159 PMCID: PMC6381138 DOI: 10.1038/s41598-019-38921-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/11/2019] [Indexed: 12/18/2022] Open
Abstract
Endothelial colony forming progenitor cell (ECFC) function is compromised in diabetes, leading to poor vascular endothelial repair, which contributes to impaired diabetic foot ulcer healing. We have generated novel glycomimetic drugs with protective effects against endothelial dysfunction. We investigated the effect of glycomimetic C3 on the functional capacity of diabetic ECFCs. ECFCs were isolated from healthy controls and patients with diabetes with neuroischaemic (NI) or neuropathic (NP) foot ulcers. Functionally, diabetic ECFCs demonstrated delayed colony formation (p < 0.02), differential proliferative capacity (p < 0.001) and reduced NO bioavailability (NI ECFCs; p < 0.05). Chemokinetic migration and angiogenesis were also reduced in diabetic ECFCs (p < 0.01 and p < 0.001), and defects in wound closure and tube formation were apparent in NP ECFCs (p < 0.01). Differential patterns in mitochondrial activity were pronounced, with raised activity in NI and depressed activity in NP cells (p < 0.05). The application of glycomimetic improved scratch wound closure in vitro in patient ECFCs (p < 0.01), most significantly in NI cells (p < 0.001), where tube formation (p < 0.05) was also improved. We demonstrate restoration of the deficits in NI cells but not NP cells, using a novel glycomimetic agent, which may be advantageous for therapeutic cell transplantation or as a localised treatment for NI but not NP patients.
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The association of plasma peroxiredoxin 3 with insulin in pregnant women. Biochem Biophys Res Commun 2019; 508:805-810. [DOI: 10.1016/j.bbrc.2018.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 12/04/2018] [Indexed: 01/08/2023]
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Influence of Active Exposure to Tobacco Smoke on Nitric Oxide Status of Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122719. [PMID: 30513890 PMCID: PMC6313314 DOI: 10.3390/ijerph15122719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022]
Abstract
Smoking tobacco can impair proper vascular endothelial functioning. This is exhibited through reduced nitric oxide synthesis as well as activity due to accompanying oxidative stress. We examined the relationship between nitric oxide and markers of oxidative stress/antioxidant defense in serum of smoking and non-smoking pregnant women. Subjects included 99 healthy pregnant women, who were tested for nitric oxide (NO), endothelial (eNOS) and inducible (iNOS) nitric oxide synthase, total oxidant capacity (TOC), and total antioxidant capacity (TAC). NO, eNOS, and TAC serum concentrations were significantly lower (p < 0.005), but iNOS (p < 0.05) and TOC (p < 0.001) were higher in smokers than in non-smokers. Multivariate regression analysis showed associations between NO concentration and eNOS, TAC, and smoking status in the whole group of patients. In the model estimated separately for smokers, the highest impact of eNOS (β = 0.375; p = 0.021) and cotinine (β = −0.323; p = 0.037) was indicated for NO concentration. In the model of non-smokers, eNOS (β = 0.291, p = 0.030) and TAC (β = 0.350; p = 0.015) were important for NO level. Smoking during pregnancy could exacerbate oxidative stress, impair the action of nitric oxide synthases, and adversely affect the balance of oxygen and nitrogen metabolism. Relationships between NO concentrations and TAC in the studied women’s blood can confirm the antioxidant nature of nitric oxide.
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Gestational diabetes alters microRNA signatures in human feto-placental endothelial cells depending on fetal sex. Clin Sci (Lond) 2018; 132:2437-2449. [DOI: 10.1042/cs20180825] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 12/12/2022]
Abstract
MicroRNAs (miRNAs), small non-coding RNAs, have emerged as important, epigenetic regulators of endothelial function. Metabolic disturbances such as diabetes alter miRNA expression. In adults, the miRNA transcriptome as well as endothelial function differ between the sexes. Here, we hypothesized that metabolic disturbances associated with gestational diabetes (GDM) alter miRNA signatures in feto-placental endothelial cells (fpEC), dependent on fetal sex. We isolated human primary fpEC after normal and GDM-complicated pregnancies with male and female neonates and screened for differential miRNA expression using next-generation miRNA sequencing. To test for miRNAs commonly regulated in fpEC of female and male progeny, data were stratified for fetal sex and maternal body mass index (BMI). Analyses were also performed separately for female and male fpEC, again accounting for maternal BMI as covariate. Potential biological pathways regulated by the altered set of miRNAs were determined using mirPath software. Maternal GDM altered 26 miRNA signatures when male and female fpEC were analyzed together. Separate analysis of male versus female fpEC revealed 22 GDM affected miRNAs in the females and only 4 in the males, without overlap. Biological functions potentially modulated by the affected miRNAs related to ‘Protein Processing in Endoplasmic Reticulum’ and ‘Proteoglycans in Cancer’. Maternal GDM alters miRNA signatures in fpEC, and biological functions affected by these miRNAs relate to well-known adverse functional consequences of diabetes on endothelium. GDM effects were highly dependent on fetal sex with miRNA signatures in female fpEC being more susceptible to metabolic derangements of GDM than miRNAs in male fpEC.
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Tarnowski M, Tkacz M, Dziedziejko V, Safranow K, Pawlik A. COX2 and NOS3 gene polymorphisms in women with gestational diabetes. J Gene Med 2018; 19. [PMID: 28474840 DOI: 10.1002/jgm.2959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/12/2017] [Accepted: 05/01/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Gestational diabetes (GDM) is carbohydrate intolerance occurring in pregnancy. Low-grade inflammation plays an important role in the pathogenesis of this disorder. The present study aimed to examine the association between COX2 (rs6681231) and NOS3 (rs1799983 and rs2070744) gene polymorphisms and GDM. METHODS The study included 204 pregnant women with GDM and 207 pregnant women with normal glucose tolerance. The diagnosis of GDM was based on a 75-g oral glucose tolerance test at 24-28 weeks of gestation. RESULTS We observed an increased frequency of COX2 rs6681231 CC and GC genotype carriers among women with GDM (CC + GC versus GG, odds ratio = 1.55, 95% confidence interval = 1.01-2.36, p = 0.043; C versus G, odds ratio = 1.59, 95% confidence interval = 1.10-2.30, p = 0.013). There were no statistically significant differences in the distribution of NOS3 rs1799983 and rs2070744 between GDM and healthy women. Moreover, among women treated with insulin, we observed an increased frequency of COX2 rs6681231 CC and NOS3 rs1799983 TT genotype carriers. CONCLUSIONS The results of the present study suggest that the CC genotype of the COX2 rs6681231 polymorphism is associated with an increased risk of GDM and the need for insulin therapy, whereas the TT genotype of the NOS3 rs1799983 polymorphism may be associated with the need for insulin therapy in women with GDM.
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Affiliation(s)
- Maciej Tarnowski
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Marta Tkacz
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
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Peng HY, Li HP, Li MQ. High glucose induces dysfunction of human umbilical vein endothelial cells by upregulating miR-137 in gestational diabetes mellitus. Microvasc Res 2018; 118:90-100. [PMID: 29505767 DOI: 10.1016/j.mvr.2018.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/07/2018] [Accepted: 03/01/2018] [Indexed: 01/12/2023]
Abstract
Recent studies have revealed considerable dysfunction of vascular endothelial cells (VECs) and abnormal expression of microRNA (miR)-137 in women with gestational diabetes mellitus (GDM), and the aim of this study was to clarify the underlying mechanism and possible role of microRNA (miR)-137 in dysfunction of VECs during GDM. We found increased levels of miR-137 in the plasma of GDM women and high-glucose (HG)-exposed HUVECs. Upregulating miR-137 in HUVECs elevated the chemokine (C-C motif) ligand 2 (CCL2) secretion and enhanced the chemotaxis and adhesion of U937 and THP-1 (two human acute monocytic leukemia cell lines) cells to HUVECs in a co-culture system. Moreover, HG stimulation and/or overexpression of miR-137 inhibited the viability, upregulated the expression levels of vascular cell adhesion molecule-1 (VCAM-1), intercellular cell adhesion molecule-1 (ICAM-1), E-selectin, and inflammatory cytokine interleukin (IL)-6, and downregulated the production of IL-8, vascular endothelial growth factor (VEGF), and angiogenesis of HUVECs in vitro. These results imply that up-regulated miR-137 by HG can restrict the viability and angiogenesis, promote the activation and inflammatory cytokine secretion of VECs, and stimulate the monocyte chemotaxis and adhesion to VECs. Ultimately, we have concluded that miR-137 is crucial to HG-induced VEC dysfunction and may be involved in pathology of GDM.
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Affiliation(s)
- Hai-Yan Peng
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China
| | - Hua-Ping Li
- Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, People's Republic of China.
| | - Ming-Qing Li
- Laboratory for Reproductive Immunology, Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People's Republic of China; Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai 200032, People's Republic of China
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Offspring sex impacts DNA methylation and gene expression in placentae from women with diabetes during pregnancy. PLoS One 2018; 13:e0190698. [PMID: 29470513 PMCID: PMC5823368 DOI: 10.1371/journal.pone.0190698] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 12/19/2017] [Indexed: 12/21/2022] Open
Abstract
Aims/Hypothesis We hypothesized that diabetes during pregnancy (DDP) alters genome-wide DNA methylation in placenta resulting in differentially methylated loci of metabolically relevant genes and downstream changes in RNA and protein expression. Methods We mapped genome-wide DNA methylation with the Infinium 450K Human Methylation Bead Chip in term fetal placentae from Native American and Hispanic women with DDP using a nested case-control design (n = 17 pairs). RNA expression and protein levels were assayed via RNA-Seq and Western Blot. Results Genome-wide DNA methylation analysis revealed 465 CpG sites with significant changes for male offspring, 247 for female offspring, and 277 for offspring of both sexes (p<0.001). Placentae from female offspring were 40% more likely to have significant gains in DNA methylation compared with placentae from male offspring exposed to DDP (p<0.001). Changes in DNA methylation corresponded to changes in RNA and protein levels for 6 genes: PIWIL3, CYBA, GSTM1, GSTM5, KCNE1 and NXN. Differential DNA methylation was detected at loci related to mitochondrial function, DNA repair, inflammation, oxidative stress. Conclusions/Interpretation These findings begin to explain mechanisms responsible for the increased risk for obesity and type 2 diabetes in offspring of mothers with DDP.
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Mirghani Dirar A, Doupis J. Gestational diabetes from A to Z. World J Diabetes 2017; 8:489-511. [PMID: 29290922 PMCID: PMC5740094 DOI: 10.4239/wjd.v8.i12.489] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 10/24/2017] [Accepted: 10/30/2017] [Indexed: 02/05/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy. This definition includes cases of undiagnosed type 2 diabetes mellitus (T2DM) identified early in pregnancy and true GDM which develops later. GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2DM to the mother and foetus later in life. In addition, GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities, hypertensive disorders and hyperinsulinemia. These might result in later development of cardiovascular disease and metabolic syndrome. The understanding of the different risk factors, the pathophysiological mechanisms and the genetic factors of GDM, will help us to identify the women at risk, to develop effective preventive measures and to provide adequate management of the disease. Clinical trials have shown that T2DM can be prevented in women with prior GDM, by intensive lifestyle modification and by using pioglitazone and metformin. However, a matter of controversy surrounding both screening and management of GDM continues to emerge, despite several recent well-designed clinical trials tackling these issues. The aim of this manuscript is to critically review GDM in a detailed and comprehensive manner, in order to provide a scientific analysis and updated write-up of different related aspects.
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Affiliation(s)
- AbdelHameed Mirghani Dirar
- Prince Abdel Aziz Bin Musaad Hospital, Diabetes and Endocrinology Center, Arar 91421, North Zone Province, Saudi Arabia
| | - John Doupis
- Iatriko Paleou Falirou Medical Center, Division of Diabetes and Clinical Research Center, Athens 17562, Greece
- Postgraduate Diabetes Education, Institute of Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
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Sáez T, de Vos P, Sobrevia L, Faas MM. Is there a role for exosomes in foetoplacental endothelial dysfunction in gestational diabetes mellitus? Placenta 2017; 61:48-54. [PMID: 29277271 DOI: 10.1016/j.placenta.2017.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/18/2017] [Accepted: 11/13/2017] [Indexed: 01/14/2023]
Abstract
Gestational diabetes mellitus (GDM) is a disease of pregnancy associated with endothelial dysfunction in the foetoplacental vasculature. Foetoplacental endothelial dysfunction is characterized by changes in the l-arginine-adenosine signalling pathway and inflammation. The mechanisms involved in these alterations are suggested to be hyperglycaemia, hyperinsulinemia, and oxidative stress. These conditions increase the release of exosomes, nanovesicles that are generated from diverse cell types, including endothelial cells. Since exosomes can modulate vascular function, they may play an important role in foetoplacental endothelial dysfunction seen in GDM pregnancies. In this review, we summarized current knowledge on the potential role of exosomes in foetoplacental endothelial dysfunction seen in this disease of pregnancy.
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Affiliation(s)
- Tamara Sáez
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Paul de Vos
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Luis Sobrevia
- Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, QLD 4029, Queensland, Australia.
| | - Marijke M Faas
- Immunoendocrinology, Division of Medical Biology, Department of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands; Department of Obstetrics and Gynaecology, University of Groningen and University Medical Center Groningen (UMCG), Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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Schliefsteiner C, Hirschmugl B, Kopp S, Curcic S, Bernhart EM, Marsche G, Lang U, Desoye G, Wadsack C. Maternal Gestational Diabetes Mellitus increases placental and foetal lipoprotein-associated Phospholipase A2 which might exert protective functions against oxidative stress. Sci Rep 2017; 7:12628. [PMID: 28974763 PMCID: PMC5626711 DOI: 10.1038/s41598-017-13051-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022] Open
Abstract
Increased Lipoprotein associated phospholipase A2 (LpPLA2) has been associated with inflammatory pathologies, including Type 2 Diabetes. Studies on LpPLA2 and Gestational Diabetes Mellitus (GDM) are rare, and have focused mostly on maternal outcome. In the present study, we investigated whether LpPLA2 activity on foetal lipoproteins is altered by maternal GDM and/or obesity (a major risk factor for GDM), thereby contributing to changes in lipoprotein functionality. We identified HDL as the major carrier of LpPLA2 activity in the foetus, which is in contrast to adults. We observed marked expression of LpPLA2 in placental macrophages (Hofbauer cells; HBCs) and found that LpPLA2 activity in these cells was increased by insulin, leptin, and pro-inflammatory cytokines. These regulators were also increased in plasma of children born from GDM pregnancies. Our results suggest that insulin, leptin, and pro-inflammatory cytokines are positive regulators of LpPLA2 activity in the foeto-placental unit. Of particular interest, functional assays using a specific LpPLA2 inhibitor suggest that high-density lipoprotein (HDL)-associated LpPLA2 exerts anti-oxidative, athero-protective functions on placental endothelium and foetus. Our results therefore raise the possibility that foetal HDL-associated LpPLA2 might act as an anti-inflammatory enzyme improving vascular barrier function.
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Affiliation(s)
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Susanne Kopp
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Sanja Curcic
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Eva Maria Bernhart
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Gunther Marsche
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Uwe Lang
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Christian Wadsack
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
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Schliefsteiner C, Peinhaupt M, Kopp S, Lögl J, Lang-Olip I, Hiden U, Heinemann A, Desoye G, Wadsack C. Human Placental Hofbauer Cells Maintain an Anti-inflammatory M2 Phenotype despite the Presence of Gestational Diabetes Mellitus. Front Immunol 2017; 8:888. [PMID: 28824621 PMCID: PMC5534476 DOI: 10.3389/fimmu.2017.00888] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background Hofbauer cells (HBCs) are macrophages of the feto-placental unit. Despite the general view that these cells have an anti-inflammatory M2 phenotype, recent studies have claimed that pregnancy pathologies—e.g., gestational diabetes mellitus (GDM)—cause a switch from an M2 to an M1 pro-inflammatory phenotype in HBCs. The pilot-study presented here challenges this claim, showing that HBCs maintain anti-inflammatory properties in spite of the hyperglycemic, low-grade inflammatory environment of GDM. Methods HBCs were isolated from placentae of healthy women (N = 5) and women with GDM (N = 6) diagnosed in the second trimester. FACS was used to measure surface markers associated with either M1 or M2 phenotype on the cells. In addition, placental tissue sections were subjected to immune histochemical imaging to assess the phenotype within the tissue context. Supernatant from control and GDM HBCs was collected at defined time points and used in a multiplex ELISA-on-beads approach to assess secretion of cytokines, chemokines, and growth factors. The effect of HBC cell culture supernatant on placental endothelial activation was investigated. Results FACS and immune staining showed that, indeed, M2 markers, such as CD206 and CD209, are increased in HBCs isolated from GDM placentae. Also, the M1 marker CD86 was increased, but only by trend. Secretion of numerous cytokines, chemokines and growth factors was not changed; pro-inflammatory interleukin (IL)-1β and IL-6 release form GDM HBC was increased but not significant. Exposure to GDM HBC supernatant did not induce cell adhesion molecules (VCAM-1, selectins, vascular endothelial-cadherin) in placental endothelial cells compared to supernatant from control HBCs, an induction of intracellular adhesion molecule 1 was observed however. Conclusion Our study—although performed in a small set of patients—shows that placental macrophages maintain their anti-inflammatory, tissue remodeling M2 phenotype even in pregnancies affected by gestational diabetes. This consistent phenotype might be important for propagation of maternal tolerance toward the fetus and for protection of the fetus from a low-grade inflammatory environment.
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Affiliation(s)
- Carolin Schliefsteiner
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Miriam Peinhaupt
- Department of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - Susanne Kopp
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Jelena Lögl
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.,Department of Cell Biology, Medical University of Graz, Graz, Austria.,Department of Histology and Embryology, Medical University of Graz, Graz, Austria
| | - Ingrid Lang-Olip
- Department of Cell Biology, Medical University of Graz, Graz, Austria.,Department of Histology and Embryology, Medical University of Graz, Graz, Austria
| | - Ursula Hiden
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Akos Heinemann
- Department of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Christian Wadsack
- Perinatal Research Laboratory, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
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Aramesh MR, Dehdashtian M, Malekian A, ShahAli S, Shojaei K. Relation between fetal anthropometric parameters and cord blood adiponectin and high-sensitivity C-reactive protein in gestational diabetes mellitus. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:228-232. [PMID: 28699987 PMCID: PMC10118795 DOI: 10.1590/2359-3997000000235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The objectives were to evaluate the relation between fetal anthropometric parameters and cord blood concentration of adiponectin and high sensitivity C-reactive protein (hs-CRP). Subjects and methods: A total of 104 pregnant women (52 with gestational diabetes mellitus [GDM], 52 with normal glucose tolerance (NGT) participated. Venous cord blood samples were obtained at delivery, centrifuged and the plasma was stored at -20°C. The samples were assessed for adiponectin and hs-CRP using the ELISA method. Statistical analysis was done using SPSS software. RESULTS The adiponectin concentration was higher in the GDM group than in the NGT group (11.05 ± 4.1 µg/mL in GDM vs. 5.34 ± 2.63 µg/mL in NGT, p < 0.001). GDM was also higher in neonates delivered at later gestational ages (p < 0.001, Pearson correlation = 0.59). There was a positive correlation between cord blood adiponectin and birth weight in the GDM group (p < 0.001, Pearson correlation = 0.619) but not in the NGT group. There was no significant correlation between adiponectin and infant length or head circumference. There was also no significant difference in cord blood hs-CRP concentration between groups. No relation was found between hs-CRP and newborn anthropometric parameters. CONCLUSION In the GDM group, adiponectin concentration was considerably higher and had a positive correlation with the ponderal index and birth weight which was not found in the NGT group.
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Affiliation(s)
| | | | | | - Shiva ShahAli
- Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Kobra Shojaei
- Ahvaz Jundishapur University of Medical Sciences, Iran
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Schierz IAM, Pinello G, Piro E, Giuffrè M, La Placa S, Corsello G. Transitional hemodynamics in infants of diabetic mothers by targeted neonatal echocardiography, electrocardiography and peripheral flow study. J Matern Fetal Neonatal Med 2017; 31:1578-1585. [PMID: 28412852 DOI: 10.1080/14767058.2017.1320544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. MATERIALS AND METHODS An observational case-control study was conducted on IDM with gestational, type 1 and type 2 DM. Relevant maternal and neonatal anamnestic, clinical and laboratory data were analyzed. Electrocardiographic and echocardiographic analyses, including structural and systo-diastolic evaluation, were performed. RESULTS In 68 IDM enrolled, we observed a lower incidence of negative perinatal outcome than expected. Comparing to non-IDM, they presented larger fetal shunts, higher pulmonary pressures, early and atrial wave velocities. At 72 hours, kinesis and heart rate variability remained low. Cerebral blood flow velocities were higher. The most serious impairment of transition was in pregestational IDM. CONCLUSION Maternal DM impaired neonatal transitional hemodynamics also in asymptomatic IDM with good glycometabolic control. These results confirm the need for an early cardiologic and cerebrovascular evaluation, to identify IDM with delayed maturation at risk of worse long-term metabolic, cardiovascular, and neurodevelopmental outcome.
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Affiliation(s)
- Ingrid Anne Mandy Schierz
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Giuseppa Pinello
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Ettore Piro
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Mario Giuffrè
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Simona La Placa
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
| | - Giovanni Corsello
- a Neonatal Intensive Care Unit, A.O.U.P. "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro" , University of Palermo , Palermo , Italy
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Harrison TN, Sacks DA, Parry C, Macias M, Ling Grant DS, Lawrence JM. Acceptability of Virtual Prenatal Visits for Women with Gestational Diabetes. Womens Health Issues 2017; 27:351-355. [PMID: 28153743 DOI: 10.1016/j.whi.2016.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/03/2016] [Accepted: 12/16/2016] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Current approaches to GDM management and education are labor intensive and costly. Telemedicine offers a potential solution to reduce the time and cost burden of prenatal care for women with GDM. METHODS We assessed the acceptability of a telemedicine intervention to transmit patients' weight, blood pressure, and blood glucose measurements from wireless devices to health care providers, and to alternate "virtual office visits" with office-based prenatal visits. We administered surveys to 70 Kaiser Permanente Southern California members with GDM to assess preferences for modalities of GDM care delivery and to understand perceptions of telemedicine. We subsequently conducted 10 qualitative interviews among women with GDM to elicit perceptions about confidence and comfort with receiving care telephonically and safety concerns. Data were coded and categorized using analytic induction. RESULTS Training on these devices would increase participants' confidence in using the equipment. Continuity of care was perceived as an important factor in facilitating confidence with near universal preference for having virtual visits with the same clinician. Most participants were not concerned with the safety of their baby or themselves during the weeks without an office visit. One participant expressed an unwillingness to participate in the intervention because of a perceived association between having a high-risk pregnancy and an increased risk of pregnancy loss. CONCLUSIONS As telemedicine becomes increasingly common in health care, feedback from end users will be essential in tailoring, communicating about, and supporting the uptake and success of such programs.
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Affiliation(s)
- Teresa N Harrison
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Carly Parry
- Patient-Centered Outcomes Research Center, Improving Healthcare Systems Program, Washington, DC
| | - Mayra Macias
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Deborah S Ling Grant
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
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Meng Q, Shao L, Luo X, Mu Y, Xu W, Gao L, Xu H, Cui Y. Expressions of VEGF-A and VEGFR-2 in placentae from GDM pregnancies. Reprod Biol Endocrinol 2016; 14:61. [PMID: 27645229 PMCID: PMC5029036 DOI: 10.1186/s12958-016-0191-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/30/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy, and has important health implications for mother and child. Changes in the fetoplacental vessels may predict those in the vasculature of the developing fetus, as these have been implicated in the pathogenesis of human GDM. This study aimed to determine the differences in the localization and expression level of VEGFA and VEGFR2 between placentas of women with GDM and placentas of normal pregnancies, which is the first step in elucidating the possible roles of VEGFA and VEGFR2 in the altered uteroplacental function resulting from maternal hyperglycaemia and ultimately in the manifestation of GDM. METHODS The expressions of VEGFA and VEGFR2 mRNA and protein in 20 samples from each group were analyzed by real-time PCR, immunohistochemistry and Western blot. The placental blood barrier and angiogenesis were observed by the transmission electron microscopy (TEM) in10 GDM samples and ten controls. RESULTS The expression levels of VEGFA and VEGFR2 mRNA and protein were significantly decreased in the GDM group (P < 0.05 or 0.01). Immunohistochemical analysis showed the reduced expression of VEGFA and VEGFR2 protein in GDM-affected placental tissues, and the degenerative alterations of the terminal villi vascular. CONCLUSION The expressions of VEGFA and VEGFR-2 mRNAs and protein were reduced in GDM-affected placental tissues, suggesting that maternal GDM affects the pathophysiological function of placentas.
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Affiliation(s)
- Qian Meng
- Department of Obstetrics, Lianyungang Maternity and Child Health Care Hospital, Lianyungang, China
- The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Li Shao
- The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Xiucui Luo
- Department of Obstetrics, Lianyungang Maternity and Child Health Care Hospital, Lianyungang, China
| | - Yingping Mu
- Department of Obstetrics, Lianyungang Maternity and Child Health Care Hospital, Lianyungang, China
| | - Wen Xu
- Department of Obstetrics, Lianyungang Maternity and Child Health Care Hospital, Lianyungang, China
| | - Li Gao
- The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
| | - Haoqin Xu
- Jiangsu Institute of Planned Parenthood Research, 277 Fenghuang Xijie, Nanjing, 210036 China
| | - Yugui Cui
- The State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029 China
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Díaz-Pérez FI, Hiden U, Gauster M, Lang I, Konya V, Heinemann A, Lögl J, Saffery R, Desoye G, Cvitic S. Post-transcriptional down regulation of ICAM-1 in feto-placental endothelium in GDM. Cell Adh Migr 2016; 10:18-27. [PMID: 26761204 DOI: 10.1080/19336918.2015.1127467] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Maternal gestational diabetes (GDM) is associated with hyperglycaemia and hyperinsulinemia in the fetal circulation which consequently may induce endothelial dysfunction in the feto-placental vasculature. In fact, feto-placental vasculature reveals various morphological changes in response to GDM. The cell adhesion molecules (CAMs) ICAM-1, VCAM-1 and E-selectin promote attachment and trans-endothelial migration of leukocytes, and are up regulated in inflammation and endothelial dysfunction. Thus, we hypothesized that the GDM environment upregulates ICAM-1, VCAM-1 and E-selectin in the feto-placental endothelium. We isolated primary feto-placental endothelial cells (fpEC) after normal (n=18) and GDM pregnancy (n=11) and analyzed mRNA (RT-qPCR) and protein expression (Immunoblot) of ICAM-1, VCAM-1 and E-selectin. While other CAMs were unchanged on mRNA and protein levels, ICAM-1 protein was decreased by GDM. Further analysis revealed also a decrease in the release of soluble ICAM-1 (sICAM-1), whose levels correlated negatively with maternal BMI. We conclude that this reduction of ICAM-1 protein species is the result of post-translational regulation, since ICAM-1 mRNA expression was unchanged. In fact, miRNAs targeting ICAM-1 were upregulated in GDM fpEC. Immunohistochemistry showed weaker ICAM-1 staining in the placental endothelium after GDM pregnancies, and demonstrated ICAM-1 binding partners CD11a and CD18 expressed on leukocytes in fetal circulation and on placental tissue macrophages. This study identified reduction of ICAM-1 protein in fpEC in GDM pregnancy, which was regulated post-transcriptionally. Low ICAM-1 protein production may represent a protective, placenta-specific mechanism to avoid leukocyte transmigration into the placenta in response to GDM.
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Affiliation(s)
| | - Ursula Hiden
- a Department of Obstetrics and Gynecology , Medical University of Graz , Austria
| | - Martin Gauster
- b Institute of Cell Biology, Histology and Embryology, Medical University of Graz , Austria
| | - Ingrid Lang
- b Institute of Cell Biology, Histology and Embryology, Medical University of Graz , Austria
| | - Viktoria Konya
- c Institute of Experimental and Clinical Pharmacology, Medical University of Graz , Austria
| | - Akos Heinemann
- c Institute of Experimental and Clinical Pharmacology, Medical University of Graz , Austria
| | - Jelena Lögl
- a Department of Obstetrics and Gynecology , Medical University of Graz , Austria
| | - Richard Saffery
- d Cancer and Disease Epigenetics, Murdoch Children's Research Institute , Parkville , Victoria , Australia.,e Department of Pediatrics , University of Melbourne , Victoria , Australia
| | - Gernot Desoye
- a Department of Obstetrics and Gynecology , Medical University of Graz , Austria
| | - Silvija Cvitic
- a Department of Obstetrics and Gynecology , Medical University of Graz , Austria
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Sultan SA, Liu W, Peng Y, Roberts W, Whitelaw D, Graham AM. The Role of Maternal Gestational Diabetes in Inducing Fetal Endothelial Dysfunction. J Cell Physiol 2015; 230:2695-705. [PMID: 25808705 DOI: 10.1002/jcp.24993] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 03/19/2015] [Indexed: 12/27/2022]
Abstract
Gestational diabetes mellitus (GDM) is known to be associated with fetal endothelial dysfunction, however, the mechanisms are not fully understood. This study examines the effect of maternal diabetes on fetal endothelial function and gene expression under physiological glucose conditions (5 mM). Human umbilical vein endothelial cell (HUVEC) isolated from diabetic mothers (d.HUVEC) grew more slowly than HUVEC isolated from healthy mothers (c.HUVEC) and had delayed doubling time despite increased levels of total vascular endothelial growth factor (VEGF) expression and protein production as determined by real-time PCR and ELISA respectively. Using western blot, the levels of antiproliferative VEGF165b isoform were increased in d.HUVEC relative to c.HUVEC. Successful VEGF165b knockdown by small interfering RNA (siRNA) resulted in increased proliferation of d.HUVEC measured by MTT, compared with negative siRNA control, to similar levels measured in c.HUVEC. In addition, d.HUVEC generated excess levels of ROS as revealed by 2',7' Dichlorodihydrofluorescein Diacetate (DCFH-DA) and Nitrotetrazolium blue (NBT). Using microarray, 102 genes were differentially overexpressed between d.HUVEC versus c.HUVEC (>1.5-fold change; P < 0.05). Functional clustering analysis of these differentially expressed genes revealed participation in inflammatory responses (including adhesion) which may be related to pathological outcomes. Of these genes, ICAM-1 was validated as upregulated, confirming microarray results. Additional confirmatory immunofluorescence staining revealed increased protein expression of ICAM-1 compared with c.HUVEC which was reduced by vitamin C treatment (100 μM). Thus, maternal diabetes induces persistent alterations in fetal endothelial function and gene expression following glucose normalization and antioxidant treatment could help reverse endothelium dysfunction.
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Affiliation(s)
- Samar A Sultan
- Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wanting Liu
- School of Computing, Informatics and Media, University of Bradford, Bradford, UK
| | - Yonghong Peng
- School of Computing, Informatics and Media, University of Bradford, Bradford, UK
| | - W Roberts
- School of Medical Sciences, University of Bradford, Bradford, UK
| | - Donald Whitelaw
- Department of Diabetes and Endocrinology, Bradford Royal Infirmary, Bradford, UK
| | - Anne M Graham
- School of Medical Sciences, University of Bradford, Bradford, UK
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40
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Inflammatory and Other Biomarkers: Role in Pathophysiology and Prediction of Gestational Diabetes Mellitus. Int J Mol Sci 2015; 16:13442-73. [PMID: 26110385 PMCID: PMC4490503 DOI: 10.3390/ijms160613442] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 06/04/2015] [Indexed: 12/24/2022] Open
Abstract
Understanding pathophysiology and identifying mothers at risk of major pregnancy complications is vital to effective prevention and optimal management. However, in current antenatal care, understanding of pathophysiology of complications is limited. In gestational diabetes mellitus (GDM), risk prediction is mostly based on maternal history and clinical risk factors and may not optimally identify high risk pregnancies. Hence, universal screening is widely recommended. Here, we will explore the literature on GDM and biomarkers including inflammatory markers, adipokines, endothelial function and lipids to advance understanding of pathophysiology and explore risk prediction, with a goal to guide prevention and treatment of GDM.
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41
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Leung YPY, Kaplan GG, Coward S, Tanyingoh D, Kaplan BJ, Johnston DW, Barkema HW, Ghosh S, Panaccione R, Seow CH. Intrapartum corticosteroid use significantly increases the risk of gestational diabetes in women with inflammatory bowel disease. J Crohns Colitis 2015; 9:223-30. [PMID: 25576754 DOI: 10.1093/ecco-jcc/jjv006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Women with inflammatory bowel disease (IBD) may be at higher risk of adverse pregnancy outcomes. This study compared perinatal outcomes in women with and without IBD. METHODS The population-based Data Integration, Measurement, and Reporting (DIMR) administrative discharge database was used to identify women (≥18 years of age) in Alberta, Canada, with IBD who delivered a baby between 2006 and 2009 inclusive. Women without IBD were randomly sampled and matched in a 3:1 ratio to IBD cases by age at conception (±1 year). Odds ratios of gestational diabetes, preterm birth, low birth weight, cesarean section, and neonatal intensive care unit admission were calculated. RESULTS One hundred and sixteen IBD patients were age-matched to 381 pregnant women without IBD. Gestational diabetes, preterm birth, and cesarean section were more common in women with IBD compared with controls (6.9 versus 1.8%, p = 0.03; 12.9 versus 0.3%, p < 0.0001; 43.1 versus 21.0%, p = 0.009, respectively). On multivariate analysis, women with IBD were independently more likely to have gestational diabetes (odds ratio [OR] = 4.3; 95% confidence interval [CI] 1.2-16.3), preterm birth (OR = 19.7, 95% CI 2.2-173.9), and to deliver by cesarean section (OR = 2.7, 95% CI 1.6-4.6) after adjusting for age and smoking status. CONCLUSION Intrapartum corticosteroid use significantly increases the risk of gestational diabetes in women with IBD. Furthermore, IBD patients are at higher risk of preterm delivery and are more likely to undergo cesarean section compared with a healthy age-matched population. The finding of a higher risk of gestational diabetes is a novel finding not previously reported in the IBD literature.
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Affiliation(s)
- Yvette P Y Leung
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Coward
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Divine Tanyingoh
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Bonnie J Kaplan
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - David W Johnston
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Herman W Barkema
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Production Animal Health, University of Calgary, Calgary, Alberta, Canada
| | - Subrata Ghosh
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cynthia H Seow
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada Department of Production Animal Health, University of Calgary, Calgary, Alberta, Canada
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Floris I, Descamps B, Vardeu A, Mitić T, Posadino AM, Shantikumar S, Sala-Newby G, Capobianco G, Mangialardi G, Howard L, Dessole S, Urrutia R, Pintus G, Emanueli C. Gestational Diabetes Mellitus Impairs Fetal Endothelial Cell Functions Through a Mechanism Involving MicroRNA-101 and Histone Methyltransferase Enhancer of Zester Homolog-2. Arterioscler Thromb Vasc Biol 2015; 35:664-74. [DOI: 10.1161/atvbaha.114.304730] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective—
Gestational diabetes mellitus (GDM) produces fetal hyperglycemia with increased lifelong risks for the exposed offspring of cardiovascular and other diseases. Epigenetic mechanisms induce long-term gene expression changes in response to in utero environmental perturbations. Moreover, microRNAs (miRs) control the function of endothelial cells (ECs) under physiological and pathological conditions and can target the epigenetic machinery. We investigated the functional and expressional effect of GDM on human fetal ECs of the umbilical cord vein (HUVECs). We focused on miR-101 and 1 of its targets, enhancer of zester homolog-2 (EZH2), which trimethylates the lysine 27 of histone 3, thus repressing gene transcription. EZH2 exists as isoforms α and β.
Approach and Results—
HUVECs were prepared from GDM or healthy pregnancies and tested in apoptosis, migration, and Matrigel assays. GDM-HUVECs demonstrated decreased functional capacities, increased miR-101 expression, and reduced EZH2- β and trimethylation of histone H3 on lysine 27 levels. MiR-101 inhibition increased EZH2 expression and improved GDM-HUVEC function. Healthy HUVECs were exposed to high or normal
d
-glucose concentration for 48 hours and then tested for miR-101 and EZH2 expression. Similar to GDM, high glucose increased miR-101 expression. Chromatin immunoprecipitation using an antibody for EZH2 followed by polymerase chain reaction analyses for miR-101 gene promoter regions showed that both GDM and high glucose concentration reduced EZH2 binding to the miR-101 locus in HUVECs. Moreover, EZH2-β overexpression inhibited miR-101 promoter activity in HUVECs.
Conclusions—
GDM impairs HUVEC function via miR-101 upregulation. EZH2 is both a transcriptional inhibitor and a target gene of miR-101 in HUVECs, and it contributes to some of the miR-101-induced defects of GDM-HUVECs.
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Affiliation(s)
- Ilaria Floris
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Betty Descamps
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Antonella Vardeu
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Tijana Mitić
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Anna Maria Posadino
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Saran Shantikumar
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Graciela Sala-Newby
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Gianpiero Capobianco
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Giuseppe Mangialardi
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Lynsey Howard
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Salvatore Dessole
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Raul Urrutia
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Gianfranco Pintus
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
| | - Costanza Emanueli
- From the Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom (I.F., B.D., A.V., T.M., S.S., G.S.-N., G.M., L.H., C.E.); Laboratory of Vascular Biology, Department of Biomedical Science (I.F., A.V., M.P., G.P.) and Department of Obstetrics and Gynecology Unit (G.C., S.D.), University of Sassari, Sassari, Italy; Laboratory of Epigenetics and Chromatin Dynamics, Mayo Clinic, Rochester, MN (R.U.); and National Heart and Lung Institute, Imperial College
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Gui J, Rohrbach A, Borns K, Hillemanns P, Feng L, Hubel CA, von Versen-Höynck F. Vitamin D rescues dysfunction of fetal endothelial colony forming cells from individuals with gestational diabetes. Placenta 2015; 36:410-8. [PMID: 25684656 DOI: 10.1016/j.placenta.2015.01.195] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/20/2015] [Accepted: 01/24/2015] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Gestational diabetes (GDM) is associated with long-term cardiovascular and metabolic diseases in offspring. However, the mechanisms are not well understood. We explored whether fetal exposure to a diabetic environment is associated with fetal endothelial progenitor cell dysfunction, and whether vitamin D can reverse the impairment. METHODS Nineteen women with uncomplicated pregnancies and 18 women with GDM were recruited before delivery. Time to first appearance of endothelial colony forming cell (ECFC) colonies and number of ECFC colonies formed from culture of cord peripheral blood mononuclear cells were determined. Angiogenesis-related functions of ECFCs in vitro were tested in the presence or absence of vitamin D. RESULTS Fetal ECFCs from GDM pregnancies formed fewer colonies in culture (P = 0.04) and displayed reduced proliferation (P = 0.02), migration (P = 0.04) and tubule formation (P = 0.03) compared to uncomplicated pregnancies. Fetal ECFCs exposed to hyperglycemia in vitro exhibited less migration (P < 0.05) and less tubule formation (P < 0.05) than normoglycemic control. Vitamin D significantly improved the dysfunction of fetal ECFCs from pregnancies complicated by GDM or after exposure of healthy ECFCs to hyperglycemia. DISCUSSION Fetal ECFCs from GDM pregnancies or ECFCs exposed to hyperglycemia in vitro exhibit reduced quantity and impaired angiogenesis-related functions. Vitamin D significantly rescues these functions. These findings may have implications for vascular function of infants exposed to a diabetic intrauterine environment.
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Affiliation(s)
- J Gui
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - A Rohrbach
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
| | - K Borns
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
| | - P Hillemanns
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
| | - L Feng
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - C A Hubel
- Magee-Womens Research Institute and Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
| | - F von Versen-Höynck
- Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany.
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Lappas M. GSK3β is increased in adipose tissue and skeletal muscle from women with gestational diabetes where it regulates the inflammatory response. PLoS One 2014; 9:e115854. [PMID: 25541965 PMCID: PMC4277409 DOI: 10.1371/journal.pone.0115854] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/27/2014] [Indexed: 11/22/2022] Open
Abstract
Infection and inflammation, through their ability to increase pro-inflammatory cytokines and chemokines and adhesion molecules, are thought to play a central role in the pathophysiology of insulin resistance and type 2 diabetes. Recent studies have shown that glycogen synthase kinase 3 (GSK3) plays a central role in regulating this inflammation. There are, however, no studies on the role of GSK3 in pregnancies complicated by gestational diabetes mellitus (GDM). Thus, the aims of this study were (i) to determine whether GSK3 is increased in adipose tissue and skeletal muscle from women with GDM; and (ii) to investigate the effect of GSK3 inhibition on inflammation in the presence of inflammation induced by bacterial endotoxin lipopolysaccharide (LPS) or the pro-inflammatory cytokine IL-1β. Human omental adipose tissue and skeletal muscle were obtained from normal glucose tolerant (NGT) women and BMI-matched women with diet-control GDM at the time of Caesarean section. Western blotting was performed to determine GSK3 protein expression. Tissue explants were performed to determine the effect of the GSK3 inhibitor CHIR99021 on markers of inflammation. When compared to women with NGT, omental adipose tissue and skeletal muscle obtained from women with diet-controlled GDM had significantly higher GSK3β activity as evidenced by a decrease in the expression of GSK3β phosphorylated at serine 9. The GSK3 inhibitor CHIR99021 significantly reduced the gene expression and secretion of the pro-inflammatory cytokines TNF-α, IL-1β and IL-6; the pro-inflammatory chemokines IL-8 and MCP-1; and the adhesion molecules ICAM-1 and VCAM-1 in tissues stimulated with LPS or IL-1β. In conclusion, GSK3 activity is increased in GDM adipose tissue and skeletal muscle and regulates infection- and inflammation-induced pro-inflammatory mediators.
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Affiliation(s)
- Martha Lappas
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
- Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia
- * E-mail:
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Göbl CS, Bozkurt L, Yarragudi R, Prikoszovich T, Tura A, Pacini G, Koppensteiner R, Kautzky-Willer A. Biomarkers of endothelial dysfunction in relation to impaired carbohydrate metabolism following pregnancy with gestational diabetes mellitus. Cardiovasc Diabetol 2014; 13:138. [PMID: 25281032 PMCID: PMC4197268 DOI: 10.1186/s12933-014-0138-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 09/30/2014] [Indexed: 12/19/2022] Open
Abstract
Background History of gestational diabetes mellitus (GDM) identifies a very young population of females predisposed for type 2 diabetes and cardiovascular disease. Endothelial dysfunction might represent a shared precursor of both disorders. Hence, this study aimed to characterize endothelial biomarkers in relation to impaired insulin sensitivity and progression to overt diabetes early after index pregnancy. Methods 108 women with previous GDM and 40 controls were included three to six months after delivery and underwent specific metabolic assessments including a frequently sampled intravenous glucose tolerance test and an oral glucose tolerance test. Diabetes progression was assessed in females with pGDM over 10 years of follow-up. Circulating sICAM-1 (intracellular-adhesion-molecule-1), sVCAM-1 (vascular-cell-adhesion-molecule-1) and sE-selectin, representing biomarkers of endothelial dysfunction were assessed at baseline and annually over five years. Results Endothelial biomarkers were significantly associated with insulin sensitivity (sICAM-1: r = -0.23, p = 0.009; sVCAM-1: r = -0.22, p = 0.011; sE-selectin: r = -0.21, p = 0.018) as well as with GDM status and parameters of subtle inflammation. Analysis of long-term trajectories revealed constantly elevated sICAM-1 (p = 0.033) and sE-selectin (p = 0.007) in 25 subjects with diabetes progression. Accordingly, sE-selectin levels at the early post partum visit predicted a later development of the disease (HR =1.02 95%CI 1.01 to 1.04, p = 0.013), however, this was attenuated after adjustment for BMI. Conclusions Elevated circulating markers of endothelial dysfunction in young females with GDM history might reflect an early stage on the pathway to the manifestation of future cardiometabolic disorders. Timely identification of women at high risk and optimization of follow-up management might provide an opportunity to prevent disease progression.
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Abstract
Maternal peripheral insulin resistance and increased inflammation are two features of pregnancies, complicated by gestational diabetes mellitus (GDM). The nucleotide-binding oligomerisation domain (NOD) intracellular molecules recognise a wide range of microbial products, as well as other intracellular danger signals, thereby initiating inflammation through activation of nuclear factor κB (NFκB). The aim of this study was to determine whether levels of NOD1 and NOD2 are increased in adipose tissue of women with GDM. The effect of NOD1 and NOD2 activation on inflammation and the insulin signalling pathway was also assessed. NOD1, but not NOD2, expression was higher in omental and subcutaneous adipose tissues obtained from women with GDM when compared with those from women with normal glucose tolerance (NGT). In both omental and subcutaneous adipose tissues from NGT and GDM women, the NOD1 ligand g-d-glutamyl-meso-diaminopimelic acid (iE-DAP) significantly induced the expression and secretion of the pro-inflammatory cytokine interleukin 6 (IL6) and chemokine IL8; COX2 (PTGS2) gene expression and subsequent prostaglandin production; the expression and secretion of the extracellular matrix remodelling enzyme matrix metalloproteinase 9 (MMP9) and the gene expression and secretion of the adhesion molecules ICAM1 and VCAM1. There was no effect of the NOD2 ligand muramyl dipeptide on any of the endpoints tested. The effects of the NOD1 ligand iE-DAP were mediated via NFκB, as the NFκB inhibitor BAY 11-7082 significantly attenuated iE-DAP-induced expression and secretion of pro-inflammatory cytokines, COX2 gene expression and subsequent prostaglandin production, MMP9 expression and secretion and ICAM1 and VCAM1 gene expression and secretion. In conclusion, the present findings describe an important role for NOD1 in the development of insulin resistance and inflammation in pregnancies complicated by GDM.
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Affiliation(s)
- Martha Lappas
- ObstetricsNutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Level 4/163 Studley Road, Heidelberg, Victoria 3084, AustraliaMercy Perinatal Research CentreMercy Hospital for Women, Heidelberg, Victoria, AustraliaObstetricsNutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, Mercy Hospital for Women, University of Melbourne, Level 4/163 Studley Road, Heidelberg, Victoria 3084, AustraliaMercy Perinatal Research CentreMercy Hospital for Women, Heidelberg, Victoria, Australia
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Lappas M. Markers of endothelial cell dysfunction are increased in human omental adipose tissue from women with pre-existing maternal obesity and gestational diabetes. Metabolism 2014; 63:860-73. [PMID: 24684825 DOI: 10.1016/j.metabol.2014.03.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/10/2014] [Accepted: 03/12/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine the effect of maternal obesity and gestational diabetes mellitus (GDM) on the expression and release of genes involved in endothelial cell dysfunction in human placenta and omental adipose tissue. MATERIALS/METHODS Human placenta and omental adipose tissue were obtained from non-obese and obese normal glucose tolerant (NGT) women and women with GDM at the time of Caesarean section. Quantitative RT-PCR was performed to determine the level of expression. Tissue explants were performed to determine the release of proteins of interest. RESULTS There was no effect of pre-existing maternal obesity or GDM on placental gene expression or secretion of members of the VEGF family members (PLGF and VEGF-A expression and secretion; sFlt-1 release; VEGFR1 and VEGFR2 mRNA expression); FGFR1 mRNA expression, FGF2 mRNA expression and secretion; endoglin mRNA expression and secretion (sEng); and the adhesion molecules ICAM-1 and VCAM-1. On the other hand, in omental adipose tissue, pre-existing maternal obesity and GDM were associated with increased gene expression of PLGF, endoglin and ICAM-1 and increased secretion of PLGF, sFlt-1, FGF2, sEng and sICAM-1. There was, however, no effect of maternal pre-existing obesity and GDM on VEGF-A, VEGFR1, VEGFR2, FGFR1 and VCAM-1 expression or secretion. CONCLUSIONS This study demonstrated the presence of abnormal expression and secretion of angiogenic proteins and adhesion molecules in omental adipose tissue, but not placenta, from pregnant women with GDM and pre-existing maternal obesity. Increased angiogenic and adhesion molecules released from adipose tissue may affect angiogenesis, inflammation and or lipid and glucose metabolism in both mum and her offspring.
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Affiliation(s)
- Martha Lappas
- Obstetrics, Nutrition and Endocrinology Group, Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia; Mercy Perinatal Research Centre, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
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Izci-Balserak B, Pien GW. The relationship and potential mechanistic pathways between sleep disturbances and maternal hyperglycemia. Curr Diab Rep 2014; 14:459. [PMID: 24398662 PMCID: PMC4065785 DOI: 10.1007/s11892-013-0459-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This paper reviews recent work investigating the influence of sleep disturbances on maternal hyperglycemia, particularly gestational diabetes mellitus (GDM). The incidence and prevalence of hyperglycemia are increasing worldwide, which is cause for concern because GDM and even mild hyperglycemia are associated with adverse pregnancy outcomes. A better understanding of sleep-related risk factors for maternal hyperglycemia is an important health matter. Evidence demonstrates associations between sleep disturbances, especially sleep-disordered breathing, and hyperglycemia, but causal effects and the underlying mechanisms linking these conditions have not been fully elucidated. Subjective sleep assessments show associations between sleep disturbances and maternal hyperglycemia. There are, however, few studies using objective measures to support these findings. Large prospective studies are required to examine causal relationships between sleep disturbances and maternal hyperglycemia. There is also a need for smaller mechanistic studies to understand the pathophysiology. Furthermore, interventional studies are required to address whether improvement of sleep parameters can prevent/decrease the risk of developing maternal hyperglycemia. Taken together, the data suggests that sleep disturbances during pregnancy are important to identify and manage in order to minimize maternal hyperglycemia and GDM, and improve maternal and fetal well-being.
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Affiliation(s)
- Bilgay Izci-Balserak
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Suite 205, Philadelphia, PA, 19104, USA,
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Giri H, Chandel S, Dwarakanath LS, Sreekumar S, Dixit M. Increased endothelial inflammation, sTie-2 and arginase activity in umbilical cords obtained from gestational diabetic mothers. PLoS One 2013; 8:e84546. [PMID: 24376824 PMCID: PMC3869849 DOI: 10.1371/journal.pone.0084546] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 11/17/2013] [Indexed: 01/08/2023] Open
Abstract
Objective The aim of this study was to determine subclinical inflammation in umbilical vein derived endothelial cells (HUVECs) obtained from Asian Indian subjects with gestational diabetes (GDM) and to determine levels of angiogenic factors and arginase activity in their cord blood. Methods This case-control study included 38 control and 30 GDM subjects. Subjects were confirmed as GDM based on 75g oral glucose tolerance test (OGTT) conducted in the second trimester of pregnancy. Angiogenic markers and arginase activity were measured in cord blood by ELISA and colorimetric methods respectively. Endothelial inflammation was assessed through adhesion of PKH26-labelled leukocytes onto HUVEC monolayer obtained from the study groups. Gene and surface expression of adhesion molecules were confirmed via reverse transcription polymerase chain reaction (RT-PCR) and flow cytometry respectively. Results The study revealed increased adhesion of leukocytes to HUVECs isolated from GDM subjects compared to controls. HUVECs of babies born to GDM mothers had increased surface and mRNA expression of E-selectin. sTie2 levels were significantly higher in the cord blood for GDM subjects (3869 ± 370 ng/L) compared to controls (3045 ± 296 ng/L). Furthermore, arginase activity was higher in cord blood of GDM mothers as opposed to the control group (7.75 ± 2.4 µmoles of urea/ml/hour vs 2.88 ±0.49 µmoles of urea/ml/hour; p-value= 0.019). Spearman’s correlation analysis revealed positive correlation of cord blood arginase activity with glucose intolerance (ρ=0.596, p=0.004) and post load glucose values (ρ=0.472, p=0.031) of mothers observed during the second trimester of pregnancy. Conclusions HUVECs derived from Asian Indian GDM mothers, exhibit signs of sub-clinical endothelial inflammation along with increased levels of sTie2 and arginase activity in their cord blood serum.
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Affiliation(s)
- Hemant Giri
- Laboratory of Vascular Biology, Department of Biotechnology, Indian Institute of Technology Madras, Chennai, India
| | - Shivam Chandel
- Laboratory of Vascular Biology, Department of Biotechnology, Indian Institute of Technology Madras, Chennai, India
| | | | | | - Madhulika Dixit
- Laboratory of Vascular Biology, Department of Biotechnology, Indian Institute of Technology Madras, Chennai, India
- * E-mail:
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Zhang K, Cao J, Dong R, Du J. Early growth response protein 1 promotes restenosis by upregulating intercellular adhesion molecule-1 in vein graft. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:432409. [PMID: 24386503 PMCID: PMC3872240 DOI: 10.1155/2013/432409] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To verify the relationship between Egr-1 and vein graft restenosis and investigate the related mechanisms. METHODS Mouse vein graft models were established in Egr-1 knockout (KO) and wild-type (WT) mice. The vein grafts in the mice were taken for pathological examination and immunohistochemical analysis. The endothelial cells (ECs) were stimulated by using a computer-controlled cyclic stress unit. BrdU staining and PCR were used to detect ECs proliferation activity and Egr-1 and ICAM-1 mRNA expression, respectively. Western-blot analysis was also used to detect expression of Egr-1 and intercellular adhesion molecule-1 (ICAM-1) proteins. RESULTS The lumens of vein grafts in Egr-1 KO mice were wider than in WT mice. ECs proliferation after mechanical stretch stimulation was suppressed by Egr-1 knockout (P < 0.05). Both in vein grafts and ECs from WT mice after mechanical stretch stimulation, mRNA expression and protein of Egr-1 and ICAM-1 showed increases (P < 0.05). However, ICAM-1 expression was significantly suppressed in ECs from Egr-1 knockout mice (P < 0.05). CONCLUSIONS Egr-1 may promote ECs proliferation and result in vein graft restenosis by upregulating the expression of ICAM-1. As a key factor of vein graft restenosis, it could be a target for the prevention of restenosis after CABG surgery.
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Affiliation(s)
- Kui Zhang
- Cardiac Surgery, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing 100029, China
| | - Jian Cao
- Cardiac Surgery, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing 100029, China
| | - Ran Dong
- Cardiac Surgery, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing 100029, China
| | - Jie Du
- Vessel Biology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing 100029, China
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