Malafaia Von Juliana, Mattar Rosiane, Ono Erika, Traina Evelyn, Pendeloski Karen Priscilla Tezotto, Dualib Patricia Medici, Araujo Júnior Edward, Daher Silvia
Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Obstetrics - São Paulo (SP), Brazil.
Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Medicine, Discipline of Endocrinology - São Paulo (SP), Brazil.
Rev Assoc Med Bras (1992). 2025 Mar 17;71(1):e20241283. doi: 10.1590/1806-9282.20241283. eCollection 2025.
Pregnancy in women with type 1 diabetes mellitus has been associated with adverse outcomes due to persistent hyperglycemia and impaired maternal-fetal interactions. Regulatory T cells seem to exert a critical role in this process. Pregnancy can change the profile of Treg cells and affect the outcome of pregnancy; therefore, our purpose was to characterize the profile of regulatory T cells in the peripheral blood of pregnant and nonpregnant (controls) women with type 1 diabetes mellitus.
This prospective case-control study recruited 36 women with type 1 diabetes mellitus, 16 pregnant and 20 nonpregnant. Peripheral blood samples were collected in the three trimesters of pregnancy and only once in the control group. Flow cytometry was used to assess peripheral blood T subpopulations: CD3+, CD4+, CD8+, CD4+ Treg (CD4+CD25+CD127-FOXP3+), and CD8+ Treg (CD8+CD25+FOXP3). In addition, the expression of CD4+CD25high and CD4+CD25low was analyzed.
Compared to controls, the pregnant women (regardless of the trimester) presented a lower percentage of TCD4+CD25high, TCD4+CD25low, and CD8 Treg (CD8+CD25+FOXP3+). Moreover, a higher percentage of total TCD8+ lymphocytes was observed in pregnant women than in controls.
This study reported changes in the circulating Treg cell profile that seem to be associated with pregnancy in type 1 diabetes mellitus patients and pregnancy outcomes.
1型糖尿病女性怀孕与持续高血糖及母婴相互作用受损导致的不良结局相关。调节性T细胞似乎在此过程中发挥关键作用。怀孕可改变调节性T细胞谱并影响妊娠结局；因此，我们的目的是描述1型糖尿病孕妇和非孕妇（对照组）外周血中调节性T细胞谱。
这项前瞻性病例对照研究招募了36名1型糖尿病女性，其中16名孕妇和20名非孕妇。在孕期的三个阶段采集外周血样本，对照组仅采集一次。采用流式细胞术评估外周血T亚群：CD3 +、CD4 +、CD8 +、CD4 +调节性T细胞（CD4 + CD25 + CD127 - FOXP3 +）和CD8 +调节性T细胞（CD8 + CD25 + FOXP3）。此外，分析CD4 + CD25高表达和CD4 + CD25低表达情况。
与对照组相比，孕妇（无论处于哪个孕期）的TCD4 + CD25高表达、TCD4 + CD25低表达和CD8调节性T细胞（CD8 + CD25 + FOXP3 +）百分比更低。此外，观察到孕妇的总TCD8 +淋巴细胞百分比高于对照组。
本研究报告了循环调节性T细胞谱的变化，这些变化似乎与1型糖尿病患者的妊娠及妊娠结局相关。
