Impaired Placentation and Early Pregnancy Loss in Patients with MTHFR Polymorphisms and Type-1 Diabetes Mellitus

• Published in: Fetal and pediatric pathology 2019-09, Vol.38 (5), p.376-386
• Main Authors: Gurbuz, Rumeysa Hekimoglu, Atilla, Pergin, Orgul, Gokcen, Tanacan, Atakan, Dolgun, Anil, Cakar, Ayse Nur, Beksac, Mehmet Sinan
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - etiology; Abortion, Spontaneous - genetics; Abortion, Spontaneous - metabolism; Adult; beclin 1 protein; Beclin-1 - metabolism; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - metabolism; Endometrium - metabolism; Female; Humans; insulin like growth factor 1; Insulin-Like Growth Factor I - metabolism; leukemia inhibitory factor; Leukemia Inhibitory Factor - metabolism; Methylenetetrahydrofolate Reductase (NADPH2) - genetics; Methylenetetrahydrofolate Reductase (NADPH2) - metabolism; MTHFR gene polymorphisms; Placenta - metabolism; Placentation - genetics; Polymorphism, Single Nucleotide; Pregnancy; Pregnancy in Diabetics; type 1 diabetes mellitus
• ISSN: 1551-3815; 1551-3823
• DOI: 10.1080/15513815.2019.1600623

Objective: To evaluate the impact of type-1 diabetes mellitus (DM) and methylenetetrahydrofolate reductase (MTHFR) polymorphisms on impaired placentation leading to early pregnancy loss. Methods: Miscarriage materials were obtained from eight pregnant women with type-1 DM without MTHFR polymorphism, eight with MTHFR polymorphisms without type-1 DM, and eight controls with neither DM nor MTHFR polymorphisms. Insulin-like growth factor-1 (IGF-1), leukemia inhibitory factor (LIF), and Beclin-1 expression were assessed to evaluate placentation. Results: Cytoplasmic LIF, IGF-1, and Beclin-1 expression were decreased in the superficial and glandular epithelial cells of the decidua in both study groups. LIF expression was increased in interstitial trophoblasts in the MTHFR group. IGF-1 expression was decreased in the decidual cells and interstitial trophoblasts in both study groups, while the decrease in stromal cells was noted only in type-1 DM group. Beclin-1 expression was increased in interstitial and villous trophoblasts in both study groups. Conclusion: The expression of IGF-1, LIF, and Beclin-1 are altered in both the decidua and the trophoblasts in pregnancies of women with type-1 DM and MTHFR polymorphisms, compared to normal pregnancies undergoing (elective) terminations.