Role of T-cells in diabetic pregnancy and macrosomia.

ABSTRACT

A number of studies have recently addressed the correlationship between diabetic pregnancy/macrosomia and differentiation of T-cells into Th1 and Th2 subsets. Diabetic pregnancy has been found to be associated with a decreased Th1 phenotype and IL-4 mRNA expression. In macrosomic offspring, high expression of IL-2 and IFN-gamma mRNA, but not of Th2 cytokines is observed, indicating that the Th1 phenotype is upregulated during macrosomia. T-cells of gestational diabetic rats and their macrosomic offspring seem to present a defect in signal transduction. Indeed, the recruitment of free intracellular calcium concentrations from intracellular pool in T-cells of these animals is altered. The phenotype of regulatory T-cells (T-Reg) is upregulated in diabetic pregnancy and their infants. T-cells in diabetic pregnancy and macrosomic obese offspring are in vivo activated. Adipokines and peroxisome proliferator-activated receptor-alpha (PPARalpha) also seem to modulate the pro-inflammatory cytokines in these pathologies. Hence, activation of the immune system might be considered as one of the regulatory pathways including metabolic abnormalities in these two pathologies.