Abstract
Problem: GDM has been associated with disturbances in iron homeostasis and exaggerated immune activation. We sought to investigate the extent to which placental iron storage and macrophage accumulations were altered in GDM. Method of Study: We conducted a retrospective, case-control study of archived placental tissues obtained from 22 pregnancies complicated by GDM and 22 unaffected controls. Controls were matched to cases based on maternal age, gestational age at birth, and method of delivery. Placental tissues were assessed for altered histology and CD68 and CD163 staining. Tissue iron was assessed using Prussian blue staining. Results: Maternal hematocrit levels were higher in GDM participants compared to controls (P = 0.02). The presence of meconium-laden macrophages was significantly greater within the amnion of GDM cases (adjusted odds ratio (OR) 12.51). Although the total abundance of CD68-expressing macrophages was not significantly different between groups, we detected a significantly greater abundance of CD163 expression within the chorion and decidua of cases. The total area staining positive for iron was 24% (95% confidence intervals of 2%-46%) greater in GDM placentae versus controls. Conclusion: GDM is associated with altered placental histology and increases in meconium-laden macrophages. Greater iron stores within the placentae of women with GDM is consistent with reports that iron excess is associated with an increased risk for GDM. The higher level of expression of CD163 on macrophage-like cells of the chorion and decidua in GDM suggests an increase in M2-like macrophages. Overall, our results add to growing evidence that GDM has direct effects on placental structure.
| Original language | English (US) |
|---|---|
| Article number | e13020 |
| Journal | American Journal of Reproductive Immunology |
| Volume | 80 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2018 |
Funding
We would like to thank the Digital Histology Shared Resource and the Translational Pathology Shared Resource at Vanderbilt University Medical Center, and the Vanderbilt Institute for Clinical and Translational Research (VICTR, supported by a Clinical and Translational Science Award from the National Center for Advancing Translational Sciences at the National Institutes of Health), for their assistance in this work. The authors have no conflict of interests to report. Funding for this work (for T.L.B.) was provided by the National Institutes of Health-National Institute of Diabetes & Digestive & Kidney Diseases, Grant/Award Number: F31DK108652-02. The Vanderbilt Medical Student Research Training Program (support for A.P.R.) is supported by the Vanderbilt Short Term Research Training Program for Medical Students (NIH grant DK007383), Vanderbilt Research Training in Diabetes and Endocrinology (NIH grant T32 DK007061), and the Vanderbilt Diabetes Research and Training Center (NIH grant DK20593). This work utilized the core(s) of the Vanderbilt Diabetes Research and Training Center funded by the grant DK020593 from the National Institute of Diabetes and Digestive and Kidney Disease. Stipend support for ACS was provided in part by the National Institute of General Medical Studies award for the Vanderbilt Medical-Scientist Training Program (T32GM07347) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (F30HD094345).
Keywords
- CD163
- gestational diabetes
- histology
- iron
- macrophages
- placenta
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Immunology and Allergy
- Immunology
- Reproductive Medicine
