Lacroix Marilyn, Lizotte Farah, Hivert Marie-France, Geraldes Pedro, Perron Patrice
Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Science, Université de Sherbrooke, Sherbrooke, Québec, Canada.
Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
J Endocr Soc. 2019 Sep 5;3(11):2165-2178. doi: 10.1210/js.2019-00181. eCollection 2019 Nov 1.
Gestational diabetes mellitus (GDM) is often characterized by low maternal calcifediol (25OHD) and high inflammation levels. This study aimed to determine whether placental protein expressions of CYP27B1, vitamin D receptor (VDR), and CYP24A1 are impaired in GDM and to investigate the effect of a 25OHD treatment on IL-6 secretion by GDM trophoblasts compared with normoglycemic (NG) trophoblasts. Placental tissue samples were harvested to determine protein expression of CYP27B1, VDR, and CYP24A1 by immunoblots. Isolated trophoblasts were stimulated with 25OHD concentrations (25 to 2000 nM) once a day for 3 days and IL-6 secretion was quantified (ELISA). We recruited 17 NG women, 19 women with GDM treated with diet and exercise alone (GDM-d) and 9 women with GDM who necessitated insulin therapy (GDM-i). Protein expressions of CYP27B1 and VDR were significantly higher in placental tissue from GDM-d women compared with NG women (both = 0.02), whereas no differences were detected between GDM-i and NG placental tissues. In cultured trophoblasts (two groups; n = 5 NG and n = 5 GDM-d), exposure to increasing 25OHD concentrations significantly decreased IL-6 secretion in the GDM-d group only ( = 0.006). After treatment with 25OHD (2000 nM), IL-6 secretion was lower in the GDM-d group compared with the NG group ( = 0.03). Our results suggest an upregulation of the VDR-1,25(OH)D complex bioavailability in GDM-d placentas, possibly reflecting a compensatory mechanism aiming to ensure that vitamin D can exert its genomic and nongenomic effects in the target cells of the placental-fetal unit. Our findings support an anti-inflammatory effect of vitamin D at the feto-maternal interface in GDM-d pregnancies.
妊娠期糖尿病(GDM)通常表现为母体骨化二醇(25OHD)水平低和炎症水平高。本研究旨在确定GDM患者胎盘组织中CYP27B1、维生素D受体(VDR)和CYP24A1的蛋白表达是否受损,并研究与血糖正常(NG)的滋养层细胞相比,25OHD治疗对GDM滋养层细胞分泌IL-6的影响。采集胎盘组织样本,通过免疫印迹法测定CYP27B1、VDR和CYP24A1的蛋白表达。分离的滋养层细胞每天用25OHD浓度(25至2000 nM)刺激一次,持续3天,并对IL-6分泌进行定量(ELISA)。我们招募了17名血糖正常的女性、19名仅接受饮食和运动治疗的GDM女性(GDM-d)和9名需要胰岛素治疗的GDM女性(GDM-i)。与NG女性相比,GDM-d女性胎盘组织中CYP27B1和VDR的蛋白表达显著更高(均P = 0.02),而GDM-i和NG胎盘组织之间未检测到差异。在培养的滋养层细胞中(两组;n = 5名NG和n = 5名GDM-d),仅在GDM-d组中,暴露于不断增加的25OHD浓度会显著降低IL-6分泌(P = 0.006)。用25OHD(2000 nM)治疗后,GDM-d组的IL-6分泌低于NG组(P = 0.03)。我们的结果表明,GDM-d胎盘组织中VDR-1,25(OH)D复合物的生物利用度上调,这可能反映了一种补偿机制,旨在确保维生素D能够在胎盘-胎儿单位的靶细胞中发挥其基因组和非基因组效应。我们的研究结果支持维生素D在GDM-d妊娠的母胎界面具有抗炎作用。