ADM AND SFLT-1 EXPRESSION IN PLACENTAS WITH GESTATIONAL DIABETES MELLITUS

Year 2023, Volume: 6 Issue: 1, 161 - 168, 30.04.2023

Necat Arslan , Sevda Soker , Süreyya Özdemir Başaran , Özge Kaplan , Fırat Aşır , Engin Deveci , Uğur Şeker

https://doi.org/10.36516/jocass.1269105

Abstract

Amaç: Bu çalışmada gestasyonel diyabetes mellitusta (GDM) vasküler regülasyonda rolü saptanan iki yeni protein olan Adrenomedullin (ADM) ve soluble fms-benzeri tirozin kinaz (sFlt-1)’in ekspresyon seviyelerini incelemeyi, hastalığın histopatolojisinde bu proteinlerin ekspresyon seviyelerini karşılaştırmayı ve bu proteinlerin ekspresyon yoğunluğunun hastalıkla korelasyonunu gözlemlemeyi amaçladık.
Gereç ve Yöntem: Çalışmamızda 20 Normotansif ve 20 GDM’li plasenta örneği alındı. Histolojik takip yöntemiyle takip edildi. Bu dokulardan 5µm kalınlığında kesitler alınarak Hematoksilen-Eozin, Periodic Acid Schiff (PAS) boyamaları yapıldı. İmmunünohistokimyasal olarak ADM ve sFlt-1 antikorları çalışıldı.
Bulgular: GDM grubunda; kök villuslarındaki kan damarlarında dilatasyon ve konjesyon, endotel hücrelerinde hiperplazi görüldü. Villusların dış kısmındaki sinsitiyal köprülerde artış, mononükleer hücre infiltrasyonu, maternal bölgedeki desidual hücrelerin bazılarında piknotik nükleuslar ve sitoplazma kaybı izlendi. İmmunohistokimyasal incelemede villusların sitotrofoblast ve sinsitiyotrofoblast hücrelerinde ve sinsitiyal düğümlerde negatif ADM ekspresyonu vardı. Küçük villusların bazı sitotrofoblast hücrelerinde, damar endotel hücrelerinde ve desidual hücrelerde pozitif ADM ekspresyonu görüldü. GDM grubunda sFlt-1 ekspresyonu endotel hücrelerinde, mezenşimal bağ doku içindeki bazı Hofbauer hücrelerinde, desidual hücre nükleuslarında ve membranlarında pozitif olarak gözlendi.
Sonuç: Desidual hücre membranlarında, sitotrofoblastlarda ADM pozitif ekspresyon gösterdiğinden ADM’nin glikoz yoğunluğunun belirlenmesinde ve bununla ilişkili olarak insülin regülasyonunda önemli bir düzenleyici olabileceğini düşündürmüştür. Yine sFlt-1’in maternal ve fötal bölgelerdeki endotel hücresi üzerindeki etkileri ve Hofbauer hücrelerindeki ekspresyonu, anjiyogenik etkide bu molekülün anahtar rol alabileceği kanısını uyandırmıştır.

Keywords

placenta, pas, gdm, ADM, sFLT-1

Supporting Institution

Dicle Üniversitesi Bilimsel Araştırma Projeleri Komisyonu

Project Number

TIP.18.032

ADM and SFLT-1 Expression in Placentas with Gestational Diabetes Mellitus

Abstract

Aim: In this study, we aimed to examine the expression levels of Adrenomedullin (ADM) and soluble fms-like tyrosine kinase-1 (sFlt-1), two novel proteins found to be involved in vascular regulation in gestational diabetes mellitus (GDM), to compare the expression levels of these proteins in the histopathology of the disease and to observe the correlation of the expression intensity of these proteins with the disease.
Methods: In our study, 20 healthy and 20 GDM placenta samples were obtained. Histologic follow-up was performed. 5µm thick sections were taken from these tissues and stained with Hematoxylin-Eosin and Periodic Acid Schiff (PAS). Immunohistochemically, ADM and sFlt-1 antibodies were studied.
Results: In the GDM group, vascular dilatation and congestion in stem villus, hyperplasic endothelial cells, and increased syncytial bridges in the external part of the villi, mononuclear cell infiltration, pyknotic nuclei and cytoplasm loss in some of the decidual cells in the maternal region were observed. In the immunohistochemical examination, cytotrophoblast and syncytiotrophoblast cells of villous and syncytial nodes showed negative ADM expression. ADM was positively expressed in some cytotrophoblast cells of small villi, vascular endothelial cells and decidual cells. In the GDM group, sFlt-1 expression was positive in endothelial cells, some Hofbauer cells of mesenchymal connective tissue, decidual cell nuclei and membranes.
Conclusion: ADM may be an important receptor in insulin metabolism to determine the glucose level because we found positive ADM expression in cytotrophoblasts and membranes of decidual cells. In addition, changes in endothelial cells of maternal and fetal regions and sFlt-1 expression in Hofbauer cells suggest that this molecule possibly plays a key role in the angiogenic effect.

Keywords

Placenta, GDM, PAS, hematoxylin-eosin, sFlt-1, adrenomedullin

Project Number

TIP.18.032

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