Assessment of the cellular and functional profile of amniotic membranes of diabetic pregnant women

Abstract

Gestational Diabetes Mellitus (GDM), the major endocrine disease in pregnancy, is associated with obstetric and perinatal complications. Increased insulin resistance (IR) and the development of a mild and transitory inflammatory response are physiological adaptations that occur in healthy pregnancy; however, in GDM these changes are more intense. There is a strong link between IR and immune response. The predominance of immune cells which release inflammatory cytokines and chemokines induce increased IR. On the other hand, this process is controlled by cells which secrete anti-inflammatory mediators. The placenta expresses these factors and also adipokines and innate immune components that may influence the maternal-fetal immune response and IR. The amniotic membrane has epithelial cells that interact with immunes cells and induce the release of mediators that modulate the maternal-fetal interaction. Different Toll like receptors (TLRs) are expressed at this membrane; when they are activated, they release cytokines and chemokines. There are few functional studies of human placenta and even fewer culture studies involving the fetal membranes. Our objective is to evaluate the cellular and functional profile of the amniotic membranes of diabetic and healthy pregnant women. This will allow us to detect potential differences in these profiles and the possible association of these differences with the development of GDM. Therefore we intend to assess the expression of chemokines, cytokines, adipokines and TLR receptors in the amniotic membrane of diabetic and healthy pregnant women, in basal conditions and after stimuli. (AU)