Caracterização de células natural killer periféricas em pacientes com diabetes mellitus gestacional
Arquivos
Data
2017-10-26
Autores
Borges, Camila de Moraes 
Orientadores
Daher, Silvia
Tipo
Dissertação de mestrado
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Resumo
Introdução: A fisiopatologia do Diabetes mellitus gestacional (DMG) é complexa envolvendo a participação de diversas células e mediadores imunes. Objetivo: Analisar o perfil de células Natural killers (NK) presentes no sangue periférico de gestantes com DMG. Métodos: Este foi um estudo do tipo caso-controle, que incluiu 39 pacientes normoglicêmicas (controles) e 36 com DMG cursando o 3º trimestre da gestação. As células NK CD56+16+ e suas subpopulações foram quantificadas e caracterizadas por citometria de fluxo e, após sorting foram analisadas a expressão de citocinas e quimiocinas por Multiplex. Avaliamos também a glicemia de jejum, insulina, e hemoglobina glicada. Resultados: Identificamos, correlação positiva entre a porcentagem de células NK CD16+CD56bright e os níveis séricos de IL-10 no grupo controle e entre esta subpopulação e as concentrações de TGF-B nas DMG. Quando comparamos as gestantes com sobrepeso entre si observamos que as diabéticas apresentavam maior porcentagem de células NK CD16+CD56dim e também correlação positiva entre a porcentagem de células NK CD16+CD56bright e os níveis séricos de TGF-B. Não observamos outras diferenças significantes entre os grupos. Conclusão: Neste estudo foi observado alteração no perfil de células NK e na secreção de citocinas em pacientes com sobrepeso e DMG, sugerindo que estes desequilíbrios acontecem quando estas duas condições clínicas estão associadas.
Introduction: The pathophysiology of Gestational Diabetes Mellitus (GDM) is complex involving the involvement of several immune cells and mediators. Objective: Analyze the profile of natural killers (NK) cells present in the peripheral blood of pregnant women with GDM. Method: This case-control study included 39 normoglycemic (controls) and 36 with GDM in the third trimester of gestation. The NK cells CD56+16+ and their subpopulations were quantified and characterized by flow cytometry and, after sorting, the expression of cytokines and chemokines was analyzed by Multiplex. We also evaluated fasting glycemia, insulin, and glycated hemoglobin. Results: We identified a positive correlation between the percentage of NK CD16+CD56bright cells and the serum levels of IL-10 in the control group and between this subpopulation and the concentrations of TGF-B in GDM. When we compared the overweight pregnant women each other, we observed that diabetics presented a higher percentage of NK CD16+CD56dim cells and also a positive correlation between the percentage of NK CD16+CD56bright cells and serum levels of TGF-B. We did not observe other significant differences between the groups. Conclusion: In this study, was observed changes in the NK cell profile and cytokine secretion in overweight and DMG patients, suggesting that these imbalances occur when these two clinical conditions are associated.
Introduction: The pathophysiology of Gestational Diabetes Mellitus (GDM) is complex involving the involvement of several immune cells and mediators. Objective: Analyze the profile of natural killers (NK) cells present in the peripheral blood of pregnant women with GDM. Method: This case-control study included 39 normoglycemic (controls) and 36 with GDM in the third trimester of gestation. The NK cells CD56+16+ and their subpopulations were quantified and characterized by flow cytometry and, after sorting, the expression of cytokines and chemokines was analyzed by Multiplex. We also evaluated fasting glycemia, insulin, and glycated hemoglobin. Results: We identified a positive correlation between the percentage of NK CD16+CD56bright cells and the serum levels of IL-10 in the control group and between this subpopulation and the concentrations of TGF-B in GDM. When we compared the overweight pregnant women each other, we observed that diabetics presented a higher percentage of NK CD16+CD56dim cells and also a positive correlation between the percentage of NK CD16+CD56bright cells and serum levels of TGF-B. We did not observe other significant differences between the groups. Conclusion: In this study, was observed changes in the NK cell profile and cytokine secretion in overweight and DMG patients, suggesting that these imbalances occur when these two clinical conditions are associated.
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Citação
BORGES, Camila de Moraes. Caracterização de células natural killer periféricas em pacientes com diabetes mellitus gestacional. São Paulo, 2017. Dissertação (Mestrado em Medicina: obstetrícia) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017