Immunohistochemical features of macrophages in placentas of obese women with gestational diabetes mellitus

Among the mechanisms underlying the development of placental dysfunction in obese women with gestational diabetes mellitus may be an imbalance of macrophage cells and changes in their morphological and functional state. The aim of the study was to determine the immunohistochemical features of macrophages in the placentas of obese women with gestational diabetes mellitus. The material for the morphological study was placentas from 40 women with full-term pregnancies: Group 1 – 10 placentas from women with a normal body mass index and physiological course of pregnancy, Group 2 – 10 placentas from women whose pregnancy was complicated by gestational diabetes mellitus, Group 3 – 10 placentas from obese women, Group 4 – 10 placentas from obese women whose pregnancy was complicated by gestational diabetes mellitus. When calculating the absolute number of CD68+ cells, their increase (p<0.05) was noted in groups 2–4 (Group 2 – (55.4±2.06), Group 3 – (84.9±1.58), Group 4 – (127.6±3.03) compared to Group 1 (30.3±1.21). In groups 2–4, compared with Group 1, the ratio between M1 and M2 macrophages was disturbed, as evidenced by the prevalence (p<0.05) of the absolute number of M1 macrophages over the absolute number of M2 macrophages. The presence of obesity in a pregnant woman, gestational diabetes mellitus and their combination lead, firstly, to an increase in the number of CD68+ macrophages; secondly, to a decrease in the number of M2 macrophages and an increase in the number of M1 macrophages with a corresponding imbalance between them in the fetal and maternal parts of the placenta. The macrophage imbalance in the placentas identified by the authors was minimally expressed in gestational diabetes mellitus, moderately expressed in maternal obesity, and maximally expressed in the combination of obesity and gestational diabetes mellitus. Keywords: pregnancy, placental dysfunction, cell imbalance.