The growth and development of the placenta is critical to fetal growth and development; however, little is known regarding the mechanisms controlling placental growth and development. Human placental membranes are known to possess receptors for insulin-like growth factors I and II (IGF-I and IGF-II) from early gestation, and increasing evidence supports a major role for IGF-I and/or IGF-II in fetal growth and development. Therefore, the IGFs may also play a significant role in regulating placental growth and development. We report here that an adult human liver IGF-II cDNA hybridizes to poly(A)+ RNAs of human placentas from different gestational ages. There are four placental poly(A)I RNA species that hybridize to IGF-II cDNA, the major one ofwhich is about 6000 bases. The sizes of the hybridized transcripts are the same for placentas of different gestational ages. Furthermore, the IGF-II sequences expressed in the human placenta were quantitated by dot blot hybridization. The second trimester placenta expresses more IGF-ll mRNA sequences than placenta of first trimester and term. Interestingly, the term placentas from diabetic pregnancies also express more of these sequences than those from normal pregnancies. These results suggest that there are developmental changes in the expression ofthe IGF-II gene in the placenta and that IGF-ll may promote placental growth by way of an autocrine and/or paracrine mechanism. Moreover, fetuses developing in diabetic pregnancies receive a large influx of glucose, which in turn may stimulate the expression of IGF-ll sequences in placenta, resulting in higher utilization of glucose and overgrowth of placenta. This may explain the macrosomia and high incidence of malformations and stillbirths known to result from pregnancies in diabetics.

Fetal growth and development are dependent upon the growth and development of the placenta. Control of placental growth and development is little understood. Immunoreactive insulin-like growth factor-I and -II (IGF-I and IGF-II) have been shown to be released by human placental tissue and human placental membranes have been observed to contain specific receptors for these growth factors. Furthermore, we have demonstrated the presence of IGF-II mRNA transcripts in the developing human placenta and at gestational term in placentae of diabetics. Thus, the IGFs may have a regulatory role in the growth and development of the placenta via autocrine and/or paracrine mechanism(s) of action. In this report we demonstrate the presence of four differing size species of placental poly(A)+ RNA which specifically hybridize to an IGF-I probe originally isolated from an adult human liver cDNA library and localize IGF-I and IGF-II mRNA to syncytiotrophoblasts and fibroblasts, respectively, of the placenta by in situ hybridization. The major transcript is 7500 bases in size and the remaining three transcripts are 5000, 1100, and 900 bases in length with no apparent changes from these sizes throughout gestation and at term in diabetics. Quantification by densitometry of placental IGF-I mRNA detected by dot blot hybridization indicated that first and second trimester placentae each express more IGF-I mRNA relative to that expressed in placenta at term. These results suggest that there are developmental changes in the relative amount of IGF-I mRNA expressed in the human placenta. IGF-I is, therefore, most likely important early in gestation as a placental growth factor. This time period is critical for fetal development and growth, when embryonic induction, organogenesis, and rapid cell proliferation occur.

Human insulin-like growth factor II (IGF-

Rapid growth of human fetal tissues requires insulin or insulin-like growth factors. A high rate of human fetal growth occurs between implantation and about 14 weeks of gestation. Fetal pancreatic insulin secretion begins much later. Since maternal insulin does not cross the blood/placental barrier, other sources of insulin or insulin-like growth factors may be provided for fetal development. We report here that placental polyadenylylated RNAs from the first and third trimester of normal pregnancy as well as from term pregnancies of diabetic mothers hybridize to a 32P-labeled cloned cDNA of an insulin-related sequence expressed in fetal pancreas. Moreover, placentas from diabetic women express much more of these sequences. These results suggest that insulinrelated genes are expressed in placental tissue during fetal development and may be a source of growth-promoting hormones for the human fetus. Fetuses developing in diabetic women receive a large influx of glucose. This in turn may stimulate the expression of insulin-related sequences, which may result in higher utilization of glucose, thus bringing about the macrosomia and high incidence of malformation and stillbirths known to result from pregnancies in diabetics.During the first 10 weeks of embryonic and fetal life, which is a critical period of rapid growth for the human conceptus, primary and secondary embryonic induction and organogenesis is taking place (1). Glucose is used as a major source of metabolic energy in the human fetus (2-4) and a glucose imbalance, in addition to affecting the growth of embryonic tissue, may well result in developmental abnormalities such as macrosomia, malformations, and increased rate of stillbirths, as is manifested in pregnancies of diabetic women. Insulin, a regulator of glucose metabolism, is an essential growth factor for fast-growing mammalian tissues, including human embryonic tissues (2-4); however maternal insulin does not cross the blood/placental barrier (5-8). Although it has not been established that insulin or an insulin-like growth factor is necessary for the early development of the human fetus in utero, such a requirement is not unlikely.Explants of multiple tissues from fetal mouse synthesized insulin-like somatomedin (9). The production of the insulinlike growth factors IGF-I and IGF-II is developmentally regulated, and this pattern of expression is maintained in fibroblasts derived from fetal as well as older rats (10). Receptors for insulin-like growth factors (IGF-I, IGF-II, somatomedin A, and multiplication-stimulating activity) and insulin are present in human fetal tissues at different stages of development (11). This evidence suggests that fetal growth may be regulated by insulin and/or insulin-like growth factors.The fetal pancreatic islets of Langerhans are capable of insulin synthesis only after 14 weeks of gestation, several weeks later than the critical growth period mentioned above. Further, the fetal pancreas normally exhibits only limited responses to acute changes in cord blood gl...