Botucatu Medical School, Sao Paulo State University, Botucatu 18618687, Brazil.
Division of Newborn Medicine/Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Cells. 2020 Mar 10;9(3):675. doi: 10.3390/cells9030675.
Gestational diabetes Mellitus (GDM) is a complex clinical condition that promotes pelvic floor myopathy, thus predisposing sufferers to urinary incontinence (UI). GDM usually regresses after birth. Nonetheless, a GDM history is associated with higher risk of subsequently developing type 2 diabetes, cardiovascular diseases (CVD) and UI. Some aspects of the pathophysiology of GDM remain unclear and the associated pathologies (outcomes) are poorly addressed, simultaneously raising public health costs and diminishing women's quality of life. Exosomes are small extracellular vesicles produced and actively secreted by cells as part of their intercellular communication system. Exosomes are heterogenous in their cargo and depending on the cell sources and environment, they can mediate both pathogenetic and therapeutic functions. With the advancement in knowledge of exosomes, new perspectives have emerged to support the mechanistic understanding, prediction/diagnosis and ultimately, treatment of the post-GMD outcomes. Here, we will review recent advances in knowledge of the role of exosomes in GDM and related areas and discuss the possibilities for translating exosomes as therapeutic agents in the GDM clinical setting.
妊娠期糖尿病(GDM)是一种复杂的临床病症,可导致盆底肌肉病,从而使患者易患尿失禁(UI)。GDM 通常会在分娩后消退。然而,GDM 病史与随后发生 2 型糖尿病、心血管疾病(CVD)和 UI 的风险增加有关。GDM 的某些病理生理学方面仍不清楚,相关的病理(结果)也未得到很好的解决,同时增加了公共卫生成本并降低了妇女的生活质量。外泌体是细胞作为其细胞间通讯系统的一部分产生和主动分泌的小细胞外囊泡。外泌体在其货物方面具有异质性,并且根据细胞来源和环境,它们可以介导致病和治疗功能。随着对外泌体知识的进步,出现了新的观点来支持对 GDM 后结果的机制理解、预测/诊断,最终是治疗。在这里,我们将回顾外泌体在 GDM 及相关领域中的作用的最新研究进展,并讨论将外泌体作为治疗剂在 GDM 临床环境中应用的可能性。