Histopathological study with immunohistochemical expression of vascular endothelial growth factor in placentas of hyperglycemic and diabetic women

Abstract

AIMS AND OBJECTIVES:Spectrum of hyperglycemia in pregnancy includes gestational diabetes mellitus (GDM), mild hyperglycemia, and overt diabetes. Many authors have worked on morphological changes of the placenta in diabetes, but few studies have correlated histopathological changes with vascular endothelial growth factor (VEGF) immunoexpression. The aim of this study was to detect different histopathological changes in various groups of diabetic placentas and to correlate with VEGF immunoexpression.MATERIALS AND METHODS:Pregnant women were screened for diabetes. They were subsequently divided into normoglycemic (12 cases), GDM (33 cases), mild hyperglycemic (13 cases), and overt diabetes (18 cases). Placentas collected were subjected to histopathological examination. VEGF expressions were studied by immunohistochemistry.RESULTS:Overt diabetic placenta displayed villous immaturity (44.4%), villous edema (38.9%), chorangiosis (61.1%), fibrinoid substance deposition (38.9%), and Hofbauer cell hyperplasia in 44.4% cases. GDM placentas displayed villous immaturity (45.5%), villous edema (45.5%), chorangiosis (42.4%), and fibrinoid substance deposition in 75.6% cases. Mild hyperglycemic placentas displayed villous immaturity (38.5%), chorangiosis (61.5%), and fibrinoid substance deposition in 61.5% cases. VEGF immunoexpression in GDM placentas was absent in all placental components except syncytiotrophoblast. VEGF expression in overt diabetic placentas was increased in syncytiotrophoblast and capillary endothelium compared to normoglycemic placentas. Mild hyperglycemic placentas expressed similar VEGF expression in all components when compared to normoglycemic controls. However, it displayed weak expression in vessel endothelium.CONCLUSION:Histopathological changes in diabetic placentas might be a consequence of altered or abnormal VEGF expression in diabetic placentas. Pathogenesis and VEGF expression in GDM placentas are significantly different from overt diabetic placentas.

Cinnamaldehyde mitigates placental vascular dysfunction of gestational diabetes and protects from the associated fetal hypoxia by modulating placental angiogenesis, metabolic activity and oxidative stress

“…7F). These observations were similar to placental structural abnormalities found by Furukawa et al [76], Gül et al [80] and Bhattacharjee et al [81] in response to the diabetic hyperglycemia.…”

Hyperglycemia disturbs trophoblast functions and subsequently leads to failure of uterine spiral artery remodeling

“…In placenta of women with GDM, increased VEGF, Ang, Eng and endothelin may lead to a collapse between angiogenic and anti-angiogenic factors ( 77 ). However, mild HG did not change the expression of VEGF ( 78 ). Persistent HG might thicken the placenta, increased the expression of HIF, thereby promoting the expression of angiogenic factors, such as VEGF and PIGF ( 79 ).…”

A Continuidade Do Cuidado Na Realidade Da Condição Crônica: Reflexões Sobre Atenção a Crianças Em Situação De Longa Permanência Em Um Hospital Universitário

“…A existência de diabetes implica em variadas alterações metabólicas, com liberação aumentada de mediadores inflamatórios e fatores pró-angiogênicos, como é o caso do Fator de Crescimento do Endotélio Vascular (VEGF) (BHATTACHARJEE et al, 2017). São expressos em diferentes tecidos, incluindo a placenta (CELIK-OZENCI et al, 2003VUORELA et al, 1997).…”