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Jin Z, Zhang Q, Liu K, Wang S, Yan Y, Zhang B, Zhao L. The association between interleukin family and diabetes mellitus and its complications: An overview of systematic reviews and meta-analyses. Diabetes Res Clin Pract 2024; 210:111615. [PMID: 38513987 DOI: 10.1016/j.diabres.2024.111615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To evaluate and summarize the association between interleukin (IL) concentrations and diabetes mellitus (DM) and its complications. METHODS Meta-analyses and eligible individual studies of observational studies investigating the associations between IL and DM and its complications were included. The random-effects model was used to estimate the summary effect, and the heterogeneity among studies was assessed using the Q-statistic and the I2 metric; The Egger's regression and the χ2 test were used to test for small study effects and excess significance bias. RESULTS This overview identified 34 meta-analyses that investigated the association between IL concentrations and DM and its complications. Meta-analyses of prospective studies indicated that elevated circulating IL-6 and IL-1β had predictive value for the incident of type 2 diabetes mellitus (T2DM), type 1 diabetes mellitus (T1DM) as well as gestational diabetes mellitus (GDM), and the overall Hazard Ratio (HR) of T2DM was 1.28 (95 % CI: 1.17, 1.40; P<0.001) per 1 log pg/ml increment in IL-6 levels, however, there was no correlation between circulating IL-10 levels and DM. Meanwhile, the increased level of IL-6 was significantly associated several diabetic complications (Diabetic kidney disease[DKD], diabetic peripheral neuropathy[DPN], and cognitive impairment[CI]), and for the diabetic retinopathy (DR), the levels of IL-1β, IL-8 and IL-10 in the aqueous humor and vitreous humor, but not the blood were significantly correlated with it. CONCLUSION Multiple ILs, such as the IL-6 and IL-1β, are definitively linked to DM and its complications, and they may be new targets for the diagnosis and treatment, but stronger evidence needs to be confirmed by prospective studies with larger sample sizes and longer observation periods.
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Affiliation(s)
- Zishan Jin
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; Beijing University of Chinese Medicine, Beijing 100105, China
| | - Qiqi Zhang
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Ke Liu
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Sicheng Wang
- Beijing University of Chinese Medicine, Beijing 100105, China
| | - Yan Yan
- Health Construction Administration Center, Guang' anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Boxun Zhang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Linhua Zhao
- Beijing University of Chinese Medicine, Beijing 100105, China.
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Toljic M, Nikolic N, Joksic I, Carkic J, Munjas J, Karadzov Orlic N, Milasin J. Expression of miRNAs and proinflammatory cytokines in pregnant women with gestational diabetes mellitus. J Reprod Immunol 2024; 162:104211. [PMID: 38342070 DOI: 10.1016/j.jri.2024.104211] [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: 09/25/2023] [Revised: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 02/13/2024]
Abstract
Altered microRNAs (miRNAs1) and cytokines expression levels are associated with several pregnancy-induced complications. We evaluated the profile of circulating miRNAs (miR-17, miR-29a and miR-181a) and proinflammatory cytokines (TNF-α, IL-1β, IL-6 and IL-17) in women with gestational diabetes mellitus (GDM2), as well as their potential use as GDM biomarkers. The case-control study included 65 pregnant women divided into 2 groups - GDM and control. Expression levels of miRNAs in plasma samples and cytokines mRNA isolated from peripheral blood buffy coat were analyzed by quantitative real-time PCR (qPCR3). Significant miR-29a downregulation was found in GDM compared to the control group, and was even more significant after adjustments for covariates. miR-17 and miR-181a expression levels did not differ between the examined groups. Expression levels of IL-1β were significantly higher in GDM group compared to controls, while TNF-α, IL-6 and IL-17 did not show significant changes in expression between the two groups. As jugded from the ROC curve analysis, miR-29a and IL-1β had a significant capacity to discriminate between CG and GDM. Additionally, a positive correlation was established between IL-1β and TNF-α in the GDM group. GDM appeared to be associated with altered levels of miR-29a and IL-1β making them markers of this condition.
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Affiliation(s)
- Mina Toljic
- Genetic Laboratory Department, Obstetrics and Gynecology Clinic "Narodni Front", Kraljice Natalije Street 62, 11000 Belgrade, Serbia
| | - Nadja Nikolic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
| | - Ivana Joksic
- Genetic Laboratory Department, Obstetrics and Gynecology Clinic "Narodni Front", Kraljice Natalije Street 62, 11000 Belgrade, Serbia.
| | - Jelena Carkic
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
| | - Jelena Munjas
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Street Vojvode Stepe 450, 11000 Belgrade, Serbia
| | - Natasa Karadzov Orlic
- High-Risk Pregnancy Department, Obstetrics and Gynecology Clinic "Narodni Front", School of Medicine, University of Belgrade, Kraljice Natalije Street 62, 11000 Belgrade, Serbia
| | - Jelena Milasin
- Department of Human Genetics, School of Dental Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
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Impact of inflammatory factors, hemoglobin A1c, and platelet parameters in gestational diabetes mellitus. Arch Gynecol Obstet 2023; 307:439-446. [PMID: 35362789 DOI: 10.1007/s00404-022-06528-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/14/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE The aim of this study was to evaluate the relationship among inflammatory cytokines including hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6), glycated hemoglobin A1c (HbA1c), and platelet distribution width (PDW) in women with gestational diabetes mellitus (GDM). METHODS Data on 191 pregnant women (96 women with GDM; 95 healthy controls) were extracted from routine prenatal examination records in Nanjing, China. Fasting concentrations of hs-CRP, IL-6, HbA1c, blood cell indices, and glucose at 24-28th gestational weeks were determined. RESULTS The levels of hs-CRP, IL-6, FPG, PG1h, PG2h, HbA1c, RBC, and PDW significantly were increased (P < 0.05) in GDM group. hs-CRP had a positive correlation with HbA1c and PLT (P < 0.05). The odds ratios of HbA1c and PDW were 7.817 (95% CI 1.921-31.816, P = 0.004) and 1.523 (95% CI 1.158-2.002, P = 0.003), respectively. Furthermore, AUC of the combined diagnosis of GDM including HbA1c, FPG, and PDW reached 0.754, with specificity of 80.0% and sensitivity of 60.4%. CONCLUSION Our findings support that elevated levels of hs-CRP, IL-6, HbA1c, and PDW at 24-28th gestational weeks even within the conventional normal range, may be implicated in the pathogenesis of GDM and their evaluation should be part of prenatal care routine.
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Relationship between the Dietary Inflammatory Index Score and Cytokine Levels in Chinese Pregnant Women during the Second and Third Trimesters. Nutrients 2022; 15:nu15010194. [PMID: 36615851 PMCID: PMC9824482 DOI: 10.3390/nu15010194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
The impact of dietary inflammatory potential on serum cytokine concentrations in second and third trimesters of Chinese pregnant women is not clear. A total of 175 pregnant women from the Tianjin Maternal and Child Health Education and Service Cohort (TMCHESC) were included. The dietary inflammatory index (DII) was calculated based on 24-h food records. Serum tumor necrosis factor-α (TNF-α), interleukin 1β (IL-1β), IL-6, IL-8, IL-10, C-reactive protein (CRP), and monocyte chemoattractant protein-1 (MCP-1) levels in the second and third trimesters were measured. The mean DII scores (mean ± SD) were -0.07 ± 1.65 and 0.06 ± 1.65 in the second and third trimesters, respectively. In the third trimester, IL-1β (p = 0.039) and MCP-1 (p = 0.035) levels decreased and then increased with increasing DII scores. IL-10 concentrations decreased in pregnant women whose DII scores increased between the second and third trimesters (p = 0.011). Thiamin and vitamin C were negatively correlated with MCP-1 (β = -0.879, and β = -0.003) and IL-6 (β = -0.602, and β = -0.002) levels in the third trimester. In conclusion, the DII score had a U-shaped association with cytokine levels during the third trimester. Changes in DII scores between the second and third trimesters of pregnancy were correlated with cytokine levels during the third trimester.
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Strahm AM, Mitchell AM, Pan X, Christian LM. Repetitive negative thinking during pregnancy and postpartum: Associations with mental health, inflammation, and breastfeeding. J Affect Disord 2022; 319:497-506. [PMID: 36162689 DOI: 10.1016/j.jad.2022.09.067] [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: 09/02/2021] [Revised: 08/22/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Repetitive negative thinking (RNT) is a transdiagnostic feature that predicts increased mental health risks, inflammation, and reduced engagement in health promoting behaviors. Depression, anxiety, stress, inflammation, higher body mass index (BMI), and low engagement in health behaviors are associated with adverse outcomes during pregnancy as well as postpartum. However, there is limited literature on the associations between RNT and these contributing factors in the perinatal period, an at-risk time during which women may benefit from clinical interventions directed at RNT. METHODS This study examined the contribution of RNT to inflammation [interleukin (IL)-6] and breastfeeding duration through mediating indicators of mental health and BMI. Behavioral and biological assessments occurred during late pregnancy as well as at 4-6 weeks, 4 months, 8 months, and 12 months postpartum. RESULTS RNT was positively associated with depressive symptoms, anxiety, and perceived stress (ps ≤ .001) at each assessment timepoint, with the strongest associations observed at the pregnancy assessment and significant, but attenuated, associations during postpartum (ps < .01). In modeling of the association between RNT and IL-6, the indirect effect of BMI was significant at each timepoint (95%CIs 0.0013, 0.0052). Women with lower RNT exhibited longer breastfeeding duration (p = .02). These effects were not significantly mediated by mental health indicators. CONCLUSIONS Clinically meaningful relationships, in which RNT predicts mental health, inflammation, and health behavior engagement during pregnancy and postpartum were observed. Clinical interventions to reduce RNT may have unique benefits this time. LIMITATIONS Further research is warranted to determine if therapies to reduce RNT confer unique benefits for maternal and child health.
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Affiliation(s)
- Anna M Strahm
- Behavioral Sciences, Sanford Research, Sioux Falls, SD, USA; Department of Obstetrics & Gynecology; Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
| | - Amanda M Mitchell
- Department of Counseling and Human Development, College of Education, University of Louisville, Louisville, KY, USA
| | - Xueliang Pan
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Vilotić A, Nacka-Aleksić M, Pirković A, Bojić-Trbojević Ž, Dekanski D, Jovanović Krivokuća M. IL-6 and IL-8: An Overview of Their Roles in Healthy and Pathological Pregnancies. Int J Mol Sci 2022; 23:ijms232314574. [PMID: 36498901 PMCID: PMC9738067 DOI: 10.3390/ijms232314574] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Interleukin-6 (IL-6) is an acknowledged inflammatory cytokine with a pleiotropic action, mediating innate and adaptive immunity and multiple physiological processes, including protective and regenerative ones. IL-8 is a pro-inflammatory CXC chemokine with a primary function in attracting and activating neutrophils, but also implicated in a variety of other cellular processes. These two ILs are abundantly expressed at the feto-maternal interface over the course of a pregnancy and have been shown to participate in numerous pregnancy-related events. In this review, we summarize the literature data regarding their role in healthy and pathological pregnancies. The general information related to IL-6 and IL-8 functions is followed by an overview of their overall expression in cycling endometrium and at the feto-maternal interface. Further, we provide an overview of their involvement in pregnancy establishment and parturition. Finally, the implication of IL-6 and IL-8 in pregnancy-associated pathological conditions, such as pregnancy loss, preeclampsia, gestational diabetes mellitus and infection/inflammation is discussed.
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Mora-Palazuelos C, Bermúdez M, Aguilar-Medina M, Ramos-Payan R, Ayala-Ham A, Romero-Quintana JG. Cytokine-polymorphisms associated with Preeclampsia: A review. Medicine (Baltimore) 2022; 101:e30870. [PMID: 36181055 PMCID: PMC9524891 DOI: 10.1097/md.0000000000030870] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Preeclampsia (PE) is a syndromic disorder that affects 2% to 8% of pregnancies and is diagnosed principally when hypertension appears in the second-d half of pregnancy. WHO estimates the incidence of PE to be seven times higher in developing countries than in developed countries. Severe preeclampsia/eclampsia is one of the most important causes of maternal mortality, associated with 50,000 to 100,000 annual deaths globally as well as serious fetal and neonatal morbidity and mortality, especially in developing countries. Even though evidence from family-based studies suggest PE has a heritable component, its etiology, and specific genetic contributions remain unclear. Many studies examining the genetic factors contributing to PE have been conducted, most of them are focused on single nucleotide polymorphisms (SNPs). Given that PE has a very important inflammatory component, is mandatory to examine cytokine-SNPs for elucidating all mechanisms involved in this pathology. In this review, we describe the most important cytokine-polymorphisms associated with the onset and development of PE. We aim to provide current and relevant evidence in this regard. METHODS We searched English databases such as PubMed and the National Center for Biotechnology Information. The publication time of the papers was set from the establishment of the databases to February 2022. All studies about Th1/Th2/Th17 cytokines polymorphisms were included in our study. RESULTS SNPs in IFN-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A, and IL-22 are associated with the development, early-onset and severity of PE, being the Th1/Th2/Th17 responses affected by the presence of these SNPs. CONCLUSIONS The changes in Th1/Th2/Th17 response modify processes such as placentation, control of inflammation, and vascular function. Nonetheless, association studies have shown different results depending on sample size, diagnostic, and population.
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Affiliation(s)
| | - Mercedes Bermúdez
- Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - Maribel Aguilar-Medina
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, Culiacán, México
| | - Rosalío Ramos-Payan
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, Culiacán, México
| | - Alfredo Ayala-Ham
- Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, México
| | - Jose Geovanni Romero-Quintana
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, Culiacán, México
- *Correspondence: Jose Geovanni Romero-Quintana, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa, Josefa Ortiz DE Domínguez S/N y Avenida DE las Américas, CP. 80010, Culiacán, Sinaloa, México (e-mail: )
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Oliveira-Scussel ACDM, Ferreira PTM, Resende RDS, Ratkevicius-Andrade CM, Gomes ADO, Paschoini MC, De Vito FB, Farnesi-de-Assunção TS, da Silva MV, Mineo JR, Rodrigues DBR, Rodrigues V. Association of gestational diabetes mellitus and negative modulation of the specific humoral and cellular immune response against Toxoplasma gondii. Front Immunol 2022; 13:925762. [PMID: 36203592 PMCID: PMC9531261 DOI: 10.3389/fimmu.2022.925762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022] Open
Abstract
In order to evaluate and compare the specific immune response of pregnant women (PW) chronically infected with Toxoplasma gondii, with and without gestational diabetes mellitus (GDM), and the humoral response of their respective newborns (NB), the study was carried out on 81 PW (34 GDM and 47 controls) from whose medical records the results of the oral glucose tolerance test (OGTT) were obtained, and blood samples were collected at the third trimester of pregnancy; also, on 45 NBs (20 GDM and 25 controls) from whom umbilical cord blood samples were obtained. Humoral immunity was analyzed by measuring anti-T. gondii total IgG, IgG subclasses and IgG avidity. To evaluate cellular immunity, peripheral blood mononuclear cells (PBMC) from 32 PW (16 GDM and 16 controls) were cultured, supernatant cytokines were determined, and flow cytometry was performed to analyze the expression at lymphocytes of surface molecules, cytokines and transcription factors. All PW and NBs were positive for total IgG, and the prevalent subclass was IgG1. There was a negative correlation between the OGTT glycemia of PW and the levels of total IgG, IgG1 and IgG avidity. The IgG avidity of the GDM group was significantly lower than the control group. Patients from the GDM group had a higher number of T lymphocytes expressing markers of cell activation and exhaustion (CD28 and PD-1). In the presence of T. gondii soluble antigen (STAg) the amount of CD4+ T cells producing IFN-γ, IL-10 and IL-17 was significantly lower in the GDM group, while there was no difference between groups in the number of CD4+ CD25HighFOXP3+LAP+ functional Treg cells. Additionally, under STAg stimulus, the secretion of IL-17, IL-4, TNF and IL-2 cytokines at PBMCs culture supernatant was lower in the GDM group. In conclusion, there was a correlation between the increase in blood glucose and the decrease in levels of anti-T. gondii antibodies, associated with the decreased IgG avidity in patients who develop GDM. Also, the GDM group had decreased immune responses in Th1, Th2 and Th17 profiles, suggesting an association between GDM and the negative modulation of the humoral and cellular immune responses against T. gondii.
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Affiliation(s)
- Ana Carolina de Morais Oliveira-Scussel
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Paula Tatiana Mutão Ferreira
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Renata de Souza Resende
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Cristhianne Molinero Ratkevicius-Andrade
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Angelica de Oliveira Gomes
- Laboratory of Cellular Interactions, Institute of Biological and Natural Sciences, Department of Structural Biology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Marina Carvalho Paschoini
- Institute of Health Sciences, Department of Obstetricy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fernanda Bernadelli De Vito
- Laboratory of Hematology and Hemotherapy, Institute of Health Sciences, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Thaís Soares Farnesi-de-Assunção
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Marcos Vinícius da Silva
- Laboratory of Parasitology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - José Roberto Mineo
- Laboratory of Immunology “Dr. Mário Endsfeldz Camargo”, Institute of Biomedical Sciences, Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | | | - Virmondes Rodrigues
- Laboratory of Immunology, Institute of Biological and Natural Sciences, Department of Microbiology, Immunology and Parasitology, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Early Identification of the Maternal, Placental and Fetal Dialog in Gestational Diabetes and Its Prevention. REPRODUCTIVE MEDICINE 2021. [DOI: 10.3390/reprodmed3010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Gestational diabetes mellitus (GDM) complicates between 5 and 12% of pregnancies, with associated maternal, fetal, and neonatal complications. The ideal screening and diagnostic criteria to diagnose and treat GDM have not been established and, currently, diagnostic use with an oral glucose tolerance test occurs late in pregnancy and produces poor reproducibility. Therefore, in recent years, significant research has been undertaken to identify a first-trimester biomarker that can predict GDM later in pregnancy, enable early intervention, and reduce GDM-related adverse pregnancy outcomes. Possible biomarkers include glycemic markers (fasting glucose and hemoglobin A1c), adipocyte-derived markers (adiponectin and leptin), pregnancy-related markers (pregnancy-associated plasma protein-A and the placental growth factor), inflammatory markers (C-reactive protein and tumor necrosis factor-α), insulin resistance markers (sex hormone-binding globulin), and others. This review summarizes current data on first-trimester biomarkers, the advantages, and the limitations. Large multi-ethnic clinical trials and cost-effectiveness analyses are needed not only to build effective prediction models but also to validate their clinical use.
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Ross KM, Dunkel Schetter C, Carroll JE, Mancuso RA, Breen EC, Okun ML, Hobel C, Coussons-Read M. Inflammatory and immune marker trajectories from pregnancy to one-year post-birth. Cytokine 2021; 149:155758. [PMID: 34773858 DOI: 10.1016/j.cyto.2021.155758] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/10/2021] [Accepted: 10/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pregnancy is an immunomodulatory state, with reported systematic changes in inflammatory and immune activity by pregnancy stage. Published data are inconsistent as to how inflammatory and immune markers change and recover across pregnancy and the postpartum period, or the sociodemographic, health and pregnancy-related factors that could affect biomarker trajectories. The purpose of this study is to describe inflammatory and immune marker trajectories from pregnancy to a year post-birth, and to test associations with sociodemographic, health and pregnancy-related variables. METHODS A sample of 179 pregnant women were assessed three times during pregnancy (between 8 and 36 weeks gestation) and three times during the postpartum period (between 1 and 12 months). Maternal sociodemographic characteristics, health, and pregnancy factors were obtained at study entry. Blood samples from each assessment were assayed for interleukin(IL)-6, tumor necrosis factor(TNF)α, IL-8, IL-10, and interferon(IFN)γ. Multilevel modelling was used to characterize biomarker trajectories and associations with sociodemographic and health variables. RESULTS Distinct trajectories over time emerged for each biomarker. Male pregnancies were associated with higher TNFα, IL-10, and IFNγ; higher pre-pregnancy BMI was associated with higher IL-6 and IFNγ. Nulliparity was associated with greater increases in IL-6 and TNFα. CONCLUSIONS Patterns observed for inflammatory and immune markers from pregnancy to a year postpartum support the hypothesis that the maternal immune system changes systematically across pregnancy and through an extended postpartum period. Parity, pre-pregnancy BMI and child sex are associated with inflammatory marker patterns over time. These results contribute to our understanding of how immune system activity changes from pregnancy to the post-birth period, and the factors that could affect those changes.
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Affiliation(s)
- Kharah M Ross
- Centre for Social Sciences, Athabasca University, Athabasca, AB, Canada.
| | | | - Judith E Carroll
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Roberta A Mancuso
- Department of Psychology and Neuroscience, Regis University, Denver, CO, USA
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Michele L Okun
- University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Calvin Hobel
- Cedars-Sinai Medical Centre, Los Angeles, CA, USA
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11
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Rafat D, Singh S, Nawab T, Khan F, Khan AU, Khalid S. Association of vaginal dysbiosis and gestational diabetes mellitus with adverse perinatal outcomes. Int J Gynaecol Obstet 2021; 158:70-78. [PMID: 34561861 DOI: 10.1002/ijgo.13945] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/02/2021] [Accepted: 09/23/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes and is an independent risk factor for vaginal dysbiosis. Understanding the vaginal microbiota in health and disease is essential to screen, detect, and manage complications of pregnancy. Therefore, the aims of the present study were to assess and compare vaginal dysbiosis in pregnancy in women with and without GDM and examine its impact on perinatal outcomes in our population. METHODS The present study was a prospective cohort study recruiting pregnant women. The subjects were divided into two groups (GDM and non-GDM) and were followed until delivery to assess fetomaternal outcomes. Vaginal samples were collected at 24-28 weeks and 34-38 weeks for Nugent scoring and determination of bacterial and fungal species. RESULTS The study recruited 502 pregnant women, with a final assessment of 320 mother-infant pairs (GDM n = 134; non-GDM n = 186). We found a significant association of vaginal dysbiosis with GDM and adverse perinatal outcomes. Significant differences were also seen in status of infection and its trimester-wise changes in relation to hyperglycemia. CONCLUSION By defining an association of vaginal dysbiosis with GDM and its correlation with perinatal outcomes, the present study calls for exploitation of this potential association as a new target in the prevention and treatment of GDM and in alleviating their undesired maternal and infant outcomes.
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Affiliation(s)
- Dalia Rafat
- Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sunita Singh
- Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tabassum Nawab
- Department of Community Medicine, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Fatima Khan
- Department of Microbiology, Jawaharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Asad U Khan
- Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shamsi Khalid
- Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Scazzocchio B, Filardi T, Varì R, Brunelli R, Galoppi P, Morano S, Masella R, Santangelo C. Protocatechuic acid influences immune-metabolic changes in the adipose tissue of pregnant women with gestational diabetes mellitus. Food Funct 2021; 12:7490-7500. [PMID: 34213517 DOI: 10.1039/d1fo00267h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gestational diabetes mellitus (GDM) is associated with immune metabolic changes that increase women's risk of developing metabolic disorders later in life. Nutritional intervention is a crucial component in reducing the burden of these pathological features. We examined whether protocatechuic acid (PCA), a major metabolite of anthocyanins abundant in plant food, is able to exert insulin-mimetic activity and modulate inflammation in the visceral adipose tissue (VAT) obtained at delivery, from pregnant women with GDM or normal glucose tolerance (NGT). PCA stimulated glucose uptake in the VAT from both GDM and NGT women. This capability was associated with increased phosphorylation of p38 mitogen-activated protein kinase (p38MAPK), as further demonstrated by the inhibitory effect of SB203580, a p38MAPK inhibitor, on PCA-induced glucose uptake. The GDM-VAT expressed lower adiponectin levels and PCA stimulated adiponectin release in the NGT-VAT and, albeit to a lower extent, in the GDM-VAT. Higher levels of IL6 and TNFα were secreted by the GDM-VAT compared with the NGT one, and PCA had no effects on them. PCA reduced the overexpression of vasoactive intestinal peptide receptor 2 (VPAC2) in the GDM-VAT. Further studies are needed to establish whether and how anthocyanins and food rich in these compounds may contribute to prevent or delay metabolic disorders in women with GDM.
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Affiliation(s)
- Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Gender Specific Prevention and Health Unit, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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13
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Bogdanet D, Reddin C, Murphy D, Doheny HC, Halperin JA, Dunne F, O’Shea PM. Emerging Protein Biomarkers for the Diagnosis or Prediction of Gestational Diabetes-A Scoping Review. J Clin Med 2021; 10:jcm10071533. [PMID: 33917484 PMCID: PMC8038821 DOI: 10.3390/jcm10071533] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/02/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction: Gestational diabetes (GDM), defined as hyperglycemia with onset or initial recognition during pregnancy, has a rising prevalence paralleling the rise in type 2 diabetes (T2DM) and obesity. GDM is associated with short-term and long-term consequences for both mother and child. Therefore, it is crucial we efficiently identify all cases and initiate early treatment, reducing fetal exposure to hyperglycemia and reducing GDM-related adverse pregnancy outcomes. For this reason, GDM screening is recommended as part of routine pregnancy care. The current screening method, the oral glucose tolerance test (OGTT), is a lengthy, cumbersome and inconvenient test with poor reproducibility. Newer biomarkers that do not necessitate a fasting sample are needed for the prompt diagnosis of GDM. The aim of this scoping review is to highlight and describe emerging protein biomarkers that fulfill these requirements for the diagnosis of GDM. Materials and Methods: This scoping review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for scoping reviews using Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing & Allied Health Literature (CINAHL), PubMed, Embase and Web of Science with a double screening and extraction process. The search included all articles published in the literature to July 2020. Results: Of the 3519 original database citations identified, 385 were eligible for full-text review. Of these, 332 (86.2%) were included in the scoping review providing a total of 589 biomarkers studied in relation to GDM diagnosis. Given the high number of biomarkers identified, three post hoc criteria were introduced to reduce the items set for discussion: we chose only protein biomarkers with at least five citations in the articles identified by our search and published in the years 2017-2020. When applied, these criteria identified a total of 15 biomarkers, which went forward for review and discussion. Conclusions: This review details protein biomarkers that have been studied to find a suitable test for GDM diagnosis with the potential to replace the OGTT used in current GDM screening protocols. Ongoing research efforts will continue to identify more accurate and practical biomarkers to take GDM screening and diagnosis into the 21st century.
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Affiliation(s)
- Delia Bogdanet
- College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland;
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
- Correspondence: ; Tel.: +35-38-3102-7771
| | - Catriona Reddin
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Dearbhla Murphy
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Helen C. Doheny
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Jose A. Halperin
- Divisions of Haematology, Brigham & Women’s Hospital, Boston, MA 02115, USA;
| | - Fidelma Dunne
- College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland;
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
| | - Paula M. O’Shea
- Centre for Diabetes Endocrinology and Metabolism, Galway University Hospital, Newcastle Road, H91YR71 Galway, Ireland; (C.R.); (D.M.); (H.C.D.); (P.M.O.)
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Qi X, Xing Y, Wang X. Blockade of CCL2/CCR2 Signaling Pathway Exerts Anti-Inflammatory Effects and Attenuates Gestational Diabetes Mellitus in a Genetic Mice Model. Horm Metab Res 2021; 53:56-62. [PMID: 33022739 DOI: 10.1055/a-1250-8221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The chemokine (C-C motif) ligand 2 (CCL2) and its receptor CCR2 are involved in gestational diabetes mellitus (GDM). The present study aims to explore the effects of CCL2 blocking on GDM. Serum CCL2, interleukin (IL)-6, and tumor necrosis factor (TNF)-α were determined in GDM patients and healthy volunteers. C57BL/KsJdb/+mouse was used as the GDM model and CCL2 antibody (αCCL2) was applied. Flow cytometry was applied to determine the frequency of macrophages. Quantitative reverse transcription PCR (RT-qPCR) and western blot were determined to detect the mRNA and protein expressions, respectively. Enzyme-linked immunosorbent assay (ELISA) was applied to determine the levels of inflammatory cytokines and serum insulin. Serum CCL2 was correlated with inflammatory cytokines (IL-6 and TNF-α) in the GDM patients. Besides, the results showed high expressions of CCL2 in the visceral adipose tissue (VAT) and placenta tissue in the GDM mice. Flow cytometry and immunohistochemistry (IHC) staining showed the accumulations of macrophages in these tissues. Treatment of αCCL2 attenuated the GDM symptoms and ameliorated the inflammation. Furthermore, the treatment of αCCL2 improved reproductive outcomes in the GDM mice. Blockade of CCL2 attenuated GDM symptoms and reduced inflammatory cytokines in a genetic mice model.
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Affiliation(s)
- Xinying Qi
- The Second Department of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Yanping Xing
- The Second Department of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Xuezhen Wang
- The Second Department of Obstetrics, Cangzhou Central Hospital, Cangzhou, Hebei, China
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Role of interleukin-6 (IL-6) in predicting gestational diabetes mellitus. Obstet Gynecol Sci 2020; 63:407-416. [PMID: 32689769 PMCID: PMC7393755 DOI: 10.5468/ogs.20020] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common pregnancy-associated metabolic disorder that is steadily increasing worldwide. Early diagnosis of pregnant women susceptible to GDM is the first step for deploying effective preventive treatment to reduce maternal, fetal, and neonatal complications. The diagnostic process of GDM is still controversial and interleukin-6 (IL-6) is one of the most recent markers used for the diagnosis of GDM. In this study, we aimed to systematically review the role of IL-6 in the diagnosis of GDM. In this systematic review, Google Scholar, Scopus, PubMed, ISI Web of Science, ProQuest, and MEDLINE databases were searched using the following keywords: GDM, screening, and IL-6, with the time interval 2009–2020. The quality of articles was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. Twenty-four articles with desired quality that met the inclusion criteria were selected and reviewed further. Sixteen studies showed a statistically significant association, while 8 studies did not report any relationship between IL-6 levels and GDM. Based on the results of these studies, assessing the serum IL-6 levels can be investigated a newly established diagnostic biomarker for GDM. Therefore, through early diagnosis of susceptible women, effective measures can be implemented to reduce its complications.
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Amirian A, Rahnemaei FA, Abdi F. Role of C-reactive Protein(CRP) or high-sensitivity CRP in predicting gestational diabetes Mellitus:Systematic review. Diabetes Metab Syndr 2020; 14:229-236. [PMID: 32247209 DOI: 10.1016/j.dsx.2020.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Gestational Diabetes Mellitus (GDM) is the most common disorder during pregnancy in 8-18% of pregnancies. Due to maternal and neonatal morbidity and mortality, early diagnosis and appropriate treatment have always been of interest to researchers. One of the recent cases for early diagnosis of GDM is the size of the C-reactive protein (CRP). The purpose of this review study was to investigate the role of CRP or its high sensitivity type in predicting GDM. METHODS Systematic searching of MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, and ProQuest databases between 2009 and 2019 using keywords 'Gestational Diabetes Mellitus','Screening', 'C-reactive protein',' High sensitivity CRP'was performed. The quality of articles was also assessed using the STROBE checklist. RESULTS After a thorough search of the mentioned databases, 31 articles with the desired quality were finally selected. Most of studies showed significant relationship between CRP or high-sensitivity CRP(hs-CRP) level with GDMbutthe relationship was not significant in fewstudies. CONCLUSIONS Blood levels of CRP or hs-CRP could be used as a potential indicator for GDM, but more studies are needed.
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Affiliation(s)
- Azam Amirian
- Department of Midwifery, School of Nursing and Midwifery, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Molecular Modelling of Islet β-Cell Adaptation to Inflammation in Pregnancy and Gestational Diabetes Mellitus. Int J Mol Sci 2019; 20:ijms20246171. [PMID: 31817798 PMCID: PMC6941051 DOI: 10.3390/ijms20246171] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 12/16/2022] Open
Abstract
Gestational diabetes mellitus (GDM), a metabolic disease that develops with the increase in insulin resistance during late pregnancy, is currently one of the most common complications affecting pregnancy. The polygenic nature of GDM, together with the interplay between different genetic variants with nutritional and environmental factors has hindered the full understanding of the etiology of this disease. However, an important genetic overlap has been found with type 2 diabetes mellitus (T2DM) and, as in the case of T2DM, most of the identified loci are associated with β-cell function. Early detection of GDM and adequate interventions to control the maternal glycemia are necessary to avoid the adverse outcomes for both the mother and the offspring. The in utero exposure to the diabetic milieu predispose these children for future diseases, among them T2DM, originating a vicious circle implicated in the increased prevalence of both GDM and T2DM. The involvement of inflammatory processes in the development of GDM highlights the importance of pancreatic β-cell factors able to favor the adaptation processes required during gestation, concomitantly with the protection of the islets from an inflammatory milieu. In this regard, two members of the Pax family of transcription factors, PAX4 and PAX8, together with the chromatin remodeler factor HMG20A, have gained great relevance due to their involvement in β-cell mass adaptation together with their anti-inflammatory properties. Mutations in these factors have been associated with GDM, highlighting these as novel candidates for genetic screening analysis in the identification of women at risk of developing GDM.
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