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Gestational diabetes impacts fetal precursor cell responses with potential consequences for offspring
Francisco Algaba-Chueca1,2,3, Elsa Maymó-Masip1,2,3, Miriam Ejarque1,2,3
1Servei d'Endocrinologia i Nutrició i Unitat de Recerca, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain.
Insights
Gestational diabetes mellitus (GDM) in mothers may negatively program fetal stem cells, potentially leading to offspring insulin resistance. This study reveals GDM
Area of Science:
- Reproductive Biology
- Stem Cell Biology
- Endocrinology
Background:
- Intrauterine exposure to maternal diabetes is linked to adverse offspring health outcomes.
- Fetal programming is a proposed mechanism for this association.
- The impact of gestational diabetes mellitus (GDM) on fetal stem cells remains unclear.
Purpose of the Study:
- To investigate if GDM imprints on fetal amniotic mesenchymal stem cells (AMSCs).
- To determine if GDM-induced changes in AMSCs correlate with adverse offspring outcomes.
- To explore the molecular mechanisms underlying GDM's effects on fetal development.
Main Methods:
- Prospective case-control study comparing GDM and normal glucose tolerance pregnancies.
- Isolation and characterization of AMSCs and macrophages from amniotic membranes.
- Analysis of AMSC proliferation, osteogenic potential, invasion, and chemotaxis.
- Gene expression analysis of inflammatory and anti-inflammatory markers.
- In vitro studies exposing healthy AMSCs to GDM-related conditions (hyperglycemia, hyperinsulinemia, palmitic acid).
Main Results:
- GDM-derived AMSCs showed impaired proliferation and osteogenic potential but increased invasiveness and chemotaxis.
- Upregulation of inflammatory genes (TNFα, MCP-1, CD40, CTSS) and downregulation of IL-33 in GDM AMSCs.
- Macrophages from GDM mothers exhibited higher MCP-1 expression.
- In vitro studies confirmed these GDM-associated cellular and molecular changes.
- Inflammatory gene expression correlated with maternal insulin sensitivity, BMI, and fetal metabolic parameters.
Conclusions:
- The intrauterine GDM environment can program fetal AMSCs, potentially promoting future metabolic dysfunction in offspring.
- GDM-induced alterations in fetal stem cells may directly contribute to offspring insulin resistance.
- Fetal adaptive programming under GDM conditions has significant implications for long-term offspring health.
Abstract:
Fetal programming has been proposed as a key mechanism underlying the association between intrauterine exposure to maternal diabetes and negative health outcomes in offspring. To determine whether gestational diabetes mellitus (GDM) might leave an imprint in fetal precursors of the amniotic membrane and whether it might be related to adverse outcomes in offspring, a prospective case-control study was conducted, in which amniotic mesenchymal stem cells (AMSCs) and resident macrophages were isolated from pregnant patients, with either GDM or normal glucose tolerance, scheduled for cesarean section. After characterization, functional characteristics of AMSCs were analyzed and correlated with anthropometrical and clinical variables from both mother and offspring. GDM-derived AMSCs displayed an impaired proliferation and osteogenic potential when compared with control cells, accompanied by superior invasive and chemotactic capacity. The expression of genes involved in the inflammatory response (TNFα, MCP-1, CD40, and CTSS) was upregulated in GDM-derived AMSCs, whereas anti-inflammatory IL-33 was downregulated. Macrophages isolated from the amniotic membrane of GDM mothers consistently showed higher expression of MCP-1 as well. In vitro studies in which AMSCs from healthy control women were exposed to hyperglycemia, hyperinsulinemia, and palmitic acid confirmed these results. Finally, genes involved in the inflammatory response were associated with maternal insulin sensitivity and prepregnancy body mass index, as well as with fetal metabolic parameters. These results suggest that the GDM environment could program stem cells and subsequently favor metabolic dysfunction later in life. Fetal adaptive programming in the setting of GDM might have a direct negative impact on insulin resistance of offspring.
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