Placental Telocytes in Diabetic Women: Histological and Immunohistochemical study

Background: Telocyte is a relatively newly identified cell type that was discovered in many organs including the uterus and placenta. It may play a role in regulating the contractile activity of smooth muscle cells and so the distribution of these cells in the placenta and umbilical cord is expected to affect blood flow in the uteroplacental vascular tree. Aim of the work: To study placental telocytes in diabetic pregnant patients as compared to control. Patients and methods: Thirty-seven women participated in the study; twenty-two control and fifteen diabetics. Ultrasound scanning assessing fetal biometry and umbilical artery doppler indices measurement were done. Non-stress test was also done for all cases before delivery. After delivery placental samples were taken and processed for histological and immunohistochemical study. Cd 117 and α smooth actin antibodies were used as well as collagen fibers staining. The mean number of immunopositive cells and area of collagen fibers were compared and statistically analyzed. Results: Analysis of the obstetric data revealed no significant differences in both groups as regard fetal doppler, NST, Apgar score and ultrasound estimated fetal weight. However, gestational age at time of delivery was significantly lower in the DM compared to control. Additionally, APGAR score was only marginally less in DM compared to control. The mean number of telocytes in diabetic group exhibited a significant decrease compared to the control. While myofibroblast number exhibited a significant increase in diabetic group, as well as the mean area of collagen fibers. Conclusion: Diabetic placenta exhibited a significant lower number of telocytes and a significant higher number of myofibroblasts compared to the control. Further studies are needed with larger number of cases of the same gestational age and advanced techniques to clarify the exact mechanism of cellular changes.