Th1/Th2 Dichotomy in Obese Women with Gestational Diabetes and Their Macrosomic Babies

Seck, Anta; Hichami, Aziz; Doucouré, Souleymane; Agne, Fatou Diallo; Basséne, Hubert; Bâ, Abdoulaye; Sokhna, Cheikh; Khan, Naim Akhtar; Samb, Abdoulaye

doi:10.1155/2018/8474617

Cited by 12 publications

(13 citation statements)

References 37 publications

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“…High production of IFN-γ and low level of IL-4 confirmed the proinflammatory Th1 phenotype in insulin-treated T2D pregnant women as well as in women with GDM in this study. Our results are in agreement with those of Seck et al [4] who reported the proinflammatory status in pregnant diabetic women, which could be responsible of recurrent miscarriage and spontaneous abortion [3].…”

Section: Discussionsupporting

confidence: 94%

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Th2-Immune Polarizing and Anti-Inflammatory Properties of Insulin Are Not Effective in Type 2 Diabetic Pregnancy

Fagninou

Nekoua

Sossou³

et al. 2020

Journal of Immunology Research

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Background. The implication of the immune system in the physiopathology of pregnancy complicated by diabetes has been reported. Here, we investigated the effects of insulin treatment on the frequencies of immune cell subpopulations as well as T cell-derived cytokines in type 2 diabetic (T2D) pregnancy compared to gestational diabetes mellitus (GDM). Methods. Fifteen (15) women with GDM, twenty (20) insulin-treated T2D pregnant women, and twenty-five (25) pregnant controls were selected. Immune cell subpopulation frequencies were determined in blood using flow cytometry. The proliferative capacity of T cells was performed, and serum and cell culture supernatant cytokine levels were also quantified. Results. The frequencies of total CD3+ and CD4+ T cells and nonclassical monocytes significantly increased in insulin-treated T2D pregnant women compared to pregnant controls. The proportions of CD4+ T cells as well as B cells were significantly higher in women with GDM than in pregnant controls. GDM was associated with high frequencies of total CD3+ and CD4+ T cells and B cell expansion, suggesting a concomitant activation of cellular and humoral immunity. Concomitantly, Th1/Th2 ratio, determined as IFN-γ/IL-4, was shifted towards Th1 phenotype in women with GDM and insulin-treated T2D pregnant women. Besides, isolated T cells elicited similar proliferative capacity in the three groups of women. Insulin-treated T2D pregnant women and women with GDM exhibited a low serum IL-10 level, without any change in the number of Treg cells. Conclusion. Our study showed that, despite insulin treatment, pregnant women with T2D displayed a proinflammatory status consistent with high proportions of CD3+ and CD4+ T cells, upregulation of Th1 cytokines, and low IL-10 production, suggesting a reduced immune-suppressive activity of regulatory T cells. However, GDM, although associated with proinflammatory status, has shown increased humoral immunity consistent with high proportion of CD19+ B cells. Thus, the lack of response to insulin in diabetes during pregnancy and clinical implications of these immunological parameters deserves further investigations.

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Section: Discussionsupporting

confidence: 94%

“…Several studies have gained interest into the immunopathology and physiopathology of gestational diabetes mellitus (GDM), type 1 or type 2 diabetic pregnancy [1][2][3][4]. However, few is known about the implication of immune cells in pregnancy complicated by diabetes.…”

Section: Introductionmentioning

confidence: 99%

Th2-Immune Polarizing and Anti-Inflammatory Properties of Insulin Are Not Effective in Type 2 Diabetic Pregnancy

Fagninou

Nekoua

Sossou³

et al. 2020

Journal of Immunology Research

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“…Since the blood of the fetus and the mother are shared, while the high concentrations of insulin in the mother exerted its metabolic effects on her own physiology, the development of acanthosis nigricans indicates a high degree of insulin resistance and a concomitant excess of circulating compounds such as glucose, amino acids, free fatty acids and others in the mother’s blood 29. Hence, the growing fetus was definitely exposed via the placenta to a larger load of circulating nutrients present in the mother’s circulation, event that should have led to fetal hyperinsulinaemia 30. Under such circumstance, rather than functioning as a metabolic hormone, fetal insulin might have acted as a growth factor in the fetus using various binding sites, including the insulin, IGF-I and hybrid insulin/IGF-I receptors.…”

Section: Case Discussionmentioning

confidence: 99%

Branding of subjects affected with genetic syndromes of severe short stature in developing countries

Guevara‐Aguirre

Guevara²,

Guevara³

et al. 2020

BMJ Case Rep

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In Ecuador, a developing South American country, subjects affected with genetic syndromes of severe short stature are commonly referred to as dwarfs or midgets. Furthermore, and because in earlier studies some patients had evidenced mental retardation, such abnormality is assumed to exist in all affected subjects. Herein, we present two discrete instances in which this type of branding occurs. The first is that of individuals with Laron syndrome who are still called ‘dwarfs’ and considered as having a degree of mental retardation despite evidence showing otherwise. A similar problem, that of a girl affected with a genetic syndrome of short stature, which might include mental retardation, is also discussed. Considering that stigmatising is a form of discrimination, it concerns us all. Hence, the use of derogatory terms such as midget, dwarf or cretin, that might unintentionally occur even when delivering the best and most devoted medical care, must be eliminated.

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“…It is the most common metabolic disease during pregnancy and its incidence is increasing worldwide [4,5]. As we have recently reported, GDM is one of the major endocrine abnormalities that can induce disruption of several biochemical and immunological parameters [3,[6][7]. Recently, there has been renewed interest in immunological parameters including immune cell subpopulations and cytokines which are designated as predictors of endothelial dysfunction and inflammation [8].…”

Section: Introductionmentioning

confidence: 99%

“…Sedentary and modern lifestyle in developing countries contribute to the increased prevalence of GDM [23,24]. Early diagnosis of gestational diabetes, based on biochemical and immunological parameters, could be crucial to anticipate the care of pregnant diabetic women and thus prevent the wide range of adverse consequences on the offspring, including macrosomia, fetal death, prematurity, birth trauma, respiratory distress syndrome, obesity, impaired glucose tolerance, and type 2 diabetes in adulthood [7,12,25].…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Immunological Parameters in the Risk of Gestational Diabetes Mellitus: A Pilot Study

Fagninou

Nekoua

Fiogbe

et al. 2020

Preprint

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Background : Immunological and biochemical parameters are gaining more and more importance in the prognosis of diabetes and its complications. Here we assessed the predictive power of immunological parameters correlated with biochemical ones in gestational diabetes mellitus (GDM). Material and Methods : 217 pregnant women were screened for GDM between the 2 nd and the 3 rd trimester of gestation, based on IAGDP methods in this cross-sectional descriptive study. Immunological and biochemical parameters were determined using appropriate methods. Receiver operating characteristics (ROC) curve analyses were conducted to assess the optimal cutoff and value of immunological to biochemical parameter ratios for predicting GDM. Results : 11.90% of pregnant women were diagnosed GDM positive. Serum glucose levels, total cholesterol, LDL-cholesterol, triglycerides and total proteins were significantly increased while HDL-cholesterol decreased in women with GDM compared to controls. The levels of glycosylated hemoglobin and creatinine, as well as transaminase (AST and ALT) activities did not significantly differ between GDM and pregnant controls. Total leucocytes (white blood cell), lymphocyte and platelet numbers were significantly higher in women with GDM than in pregnant controls. We also found that the lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios were significantly higher in women with GDM than in pregnant controls ( p = 0.001; p = 0.009 and p = 0.004 respectively). Women with a lymphocyte:HDL-C ratio greater than 3.66 had a 4-fold increased risk of developing GDM than those with lower ratios (odds ratio 4.00; 95% CI: 1.094 – 14.630; p =0.041). Conclusion : The lymphocyte:HDL-C, monocyte:HDL-C and granulocyte:HDL-C ratios may represent valuable makers, and the lymphocyte:HDL-C ratio in particular may have strong predictive power for GDM. This ratio can be easily assessed in patients.

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Th1/Th2 Dichotomy in Obese Women with Gestational Diabetes and Their Macrosomic Babies

Cited by 12 publications

References 37 publications

Th2-Immune Polarizing and Anti-Inflammatory Properties of Insulin Are Not Effective in Type 2 Diabetic Pregnancy

Th2-Immune Polarizing and Anti-Inflammatory Properties of Insulin Are Not Effective in Type 2 Diabetic Pregnancy

Branding of subjects affected with genetic syndromes of severe short stature in developing countries

Predictive Value of Immunological Parameters in the Risk of Gestational Diabetes Mellitus: A Pilot Study

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