Elevated First-Trimester Neutrophil Count Is Closely Associated With the Development of Maternal Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes

Sun, Tiange; Meng, Fanqi; Zhao, Hongmei; Zhang, Rui; Yu, Zhiyan; Huang, Xinmei; Ding, Hu; Zang, Shufei

doi:10.2337/db19-0976

Cited by 36 publications

(30 citation statements)

References 41 publications

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“…In addition, elevated neutrophil-derived products including nucleosomes, neutrophil elastase, and free DNA have been found in the plasma of diabetes mellitus patients [ 129 ]. Elevated first-trimester neutrophil count has also been associated with the development of GDM and adverse pregnancy outcomes [ 130 ]. In the placenta, extracellular traps formation may be triggered by infection (e.g., by bacteria or their products) or by inflammation (e.g., preeclampsia and GDM).…”

Section: Hyperglycemia-induced Metainflammation In Gdm Alters Placental Immune Cells Population Favoring An Inflammatory Cytokine Signatumentioning

confidence: 99%

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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Gestational Diabetes Mellitus (GDM) is a transitory metabolic condition caused by dysregulation triggered by intolerance to carbohydrates, dysfunction of beta-pancreatic and endothelial cells, and insulin resistance during pregnancy. However, this disease includes not only changes related to metabolic distress but also placental immunoendocrine adaptations, resulting in harmful effects to the mother and fetus. In this review, we focus on the placenta as an immuno-endocrine organ that can recognize and respond to the hyperglycemic environment. It synthesizes diverse chemicals that play a role in inflammation, innate defense, endocrine response, oxidative stress, and angiogenesis, all associated with different perinatal outcomes.

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Section: Hyperglycemia-induced Metainflammation In Gdm Alters Placental Immune Cells Population Favoring An Inflammatory Cytokine Signatumentioning

confidence: 99%

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Olmos-Ortíz

Flores-Espinosa

Díaz

et al. 2021

IJMS

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“…Many studies have reported that women with GDM had significantly higher counts of leukocytes, neutrophils, lymphocytes and monocytes ( 11 , 59 ). Furthermore, most clinical studies reported that the ratio of these cells is a suitable GDM marker - for example, an elevated neutrophil/lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) ( 11 , 60 - 62 ).…”

Section: Whole Blood Parametersmentioning

confidence: 99%

Early markers of gestational diabetes mellitus

Omazić

Viljetić

Ivić

et al. 2021

Biochem. med. (Online)

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Women’s metabolism during pregnancy undergoes numerous changes that can lead to gestational diabetes mellitus (GDM). The cause and pathogenesis of GDM, a heterogeneous disease, are not completely clear, but GDM is increasing in prevalence and is associated with the modern lifestyle. Most diagnoses of GDM are made via the guidelines from the International Association of Diabetes and Pregnancy Study Groups (IADSPG), which involve an oral glucose tolerance test (OGTT) between 24 and 28 weeks of pregnancy. Diagnosis in this stage of pregnancy can lead to short- and long-term implications for the mother and child. Therefore, there is an urgent need for earlier GDM markers in order to enable prevention and earlier treatment. Routine GDM biomarkers (plasma glucose, insulin, C-peptide, homeostatic model assessment of insulin resistance, and sex hormone-binding globulin) can differentiate between healthy pregnant women and those with GDM but are not suitable for early GDM diagnosis. In this article, we present an overview of the potential early biomarkers for GDM that have been investigated recently. We also present our view of future developments in the laboratory diagnosis of GDM.

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“…The potent reason behind this activation of the inflammasome is excessive glucose which induces NLRP3 resulting in the generation of pro-inflammatory cytokine storms mainly IL-1β and IL-18 ( Figure 2C ) ( Han et al, 2015 ; Corrêa-Silva et al, 2018 ). Excessive neutrophilia, high glycaemic levels, and increased homeostatic model assessment of insulin resistance are associated with GDM diagnosis as early as in the first trimester ( Figure 2C ) ( Sun et al, 2020 ). The increased numbers of neutrophils are intended to be more reliable than leukocyte numbers i.e., the neutrophil to leukocyte ratio is used as an inflammatory marker for diagnosis of GDM in the second trimester.…”

Section: Introductionmentioning

confidence: 99%

Immunological Changes in Pregnancy and Prospects of Therapeutic Pla-Xosomes in Adverse Pregnancy Outcomes

et al. 2022

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Stringent balance of the immune system is a key regulatory factor in defining successful implantation, fetal development, and timely parturition. Interference in these primary regulatory mechanisms, either at adolescence or prenatal state led to adverse pregnancy outcomes. Fertility restoration with the help of injectable gonadotrophins/progesterone, ovulation-inducing drugs, immunomodulatory drugs (corticosteroids), and reproductive surgeries provides inadequate responses, which manifest its own side effects. The development of a potential diagnostic biomarker and an effectual treatment for adverse pregnancy outcomes is a prerequisite to maternal and child health. Parent cell originated bi-layered-intraluminal nano-vesicles (30–150 nm) also known as exosomes are detected in all types of bodily fluids like blood, saliva, breast milk, urine, etc. Exosomes being the most biological residual structures with the least cytotoxicity are loaded with cargo in the form of RNAs (miRNAs), proteins (cytokines), hormones (estrogen, progesterone, etc.), cDNAs, and metabolites making them chief molecules of cell-cell communication. Their keen involvement in the regulation of biological processes has portrayed them as the power shots of cues to understand the disease’s pathophysiology and progression. Recent studies have demonstrated the role of immunexosomes (immunomodulating exosomes) in maintaining unwavering immune homeostasis between the mother and developing fetus for a healthy pregnancy. Moreover, the concentration and size of the exosomes are extensively studied in adverse pregnancies like preeclampsia, gestational diabetes mellitus (GDM), and preterm premature rupture of membrane (pPROMs) as an early diagnostic marker, thus giving in-depth information about their pathophysiology. Exosomes have also been engineered physically as well as genetically to enhance their encapsulation efficiency and specificity in therapy for cancer and adverse pregnancies. Successful bench to bedside discoveries and interventions in cancer has motivated developmental biologists to investigate the role of immunexosomes and their active components. Our review summarizes the pre-clinical studies for the use of these power-shots as therapeutic agents. We envisage that these studies will pave the path for the use of immunexosomes in clinical settings for reproductive problems that arise due to immune perturbance in homeostasis either at adolescence or prenatal state.

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Elevated First-Trimester Neutrophil Count Is Closely Associated With the Development of Maternal Gestational Diabetes Mellitus and Adverse Pregnancy Outcomes

Cited by 36 publications

References 41 publications

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Immunoendocrine Dysregulation during Gestational Diabetes Mellitus: The Central Role of the Placenta

Early markers of gestational diabetes mellitus

Immunological Changes in Pregnancy and Prospects of Therapeutic Pla-Xosomes in Adverse Pregnancy Outcomes

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