Zhang Lijie, Zhang Yuanyuan, Wei Lingling, Tian Dan, Zhao Dong, Yang Longyan
Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
Obstetrics Department, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
Arch Gynecol Obstet. 2024 Aug;310(2):1109-1119. doi: 10.1007/s00404-024-07513-2. Epub 2024 May 31.
There are abundant hematopoietic stem cells (HSCs) in cord blood. It is known that HSCs continue to differentiate to CLP, CMP and erythroid progenitor cells (EPC), EPC ultimately differentiated to platelets and erythrocytes. It has been reported that the proportion of HSCs in cord blood was higher than that in healthy pregnant women, so as the incidence of neonatal polycythemia in gestational diabetes mellitus (GDM) patients. We aimed to investigate whether the hyperglycemic and/or hyperinsulin environment in GDM patients has effects on the differentiation of HSCs into erythrocytes in offspring cord blood.
In this study, we collected cord blood from 23 GDM patients and 52 healthy pregnant women at delivery. HSCs, CLP, CMP and EPCs in cord blood of the two groups were identified and quantified by flow cytometry. HSCs were sorted out and treated with glucose and insulin, respectively, and then, the changes of HSCs proliferation and differentiation were detected.
Compared to healthy controls, HSCs, CMP and EPC numbers in cord blood from GDM group were significantly increased, while CLP cell number was decreased. The differentiation of HSCs into EPC was promoted after treatment with glucose or insulin.
There were more HSCs in the cord blood of GDM group, and the differentiation of HSCs to EPCs was increased. These findings were probably caused by the high-glucose microenvironment and insulin medication in GDM patients, and the HSCs differentiation changes might be influencing factors of the high incidence of neonatal erythrocytosis in GDM patients.
脐血中存在丰富的造血干细胞（HSCs）。已知造血干细胞会持续分化为共同淋巴祖细胞（CLP）、粒-单核祖细胞（CMP）和红系祖细胞（EPC），EPC最终分化为血小板和红细胞。据报道，脐血中造血干细胞的比例高于健康孕妇，妊娠期糖尿病（GDM）患者新生儿红细胞增多症的发病率也是如此。我们旨在研究GDM患者的高血糖和/或高胰岛素环境是否会影响子代脐血中造血干细胞向红细胞的分化。
在本研究中，我们在分娩时收集了23例GDM患者和52例健康孕妇的脐血。通过流式细胞术对两组脐血中的造血干细胞、CLP、CMP和EPC进行鉴定和定量。分选出血液造血干细胞，分别用葡萄糖和胰岛素处理，然后检测造血干细胞增殖和分化的变化。
与健康对照组相比，GDM组脐血中的造血干细胞、CMP和EPC数量显著增加，而CLP细胞数量减少。用葡萄糖或胰岛素处理后，造血干细胞向EPC的分化得到促进。
GDM组脐血中的造血干细胞较多，造血干细胞向EPC的分化增加。这些发现可能是由GDM患者的高糖微环境和胰岛素用药引起的，造血干细胞分化变化可能是GDM患者新生儿红细胞增多症高发的影响因素。
