The effect of vascular complications of diabetes mellitus on human umbilical cord tissue and the number of wharton jelly's mesenchymal stem cells

Diabetes Mellitus (DM) is a metabolic disease that is associated with aberrant blood sugar level, which occurs as a result of insufficient and/or ineffective insulin. DM has affects on body metabolism and tissues and mostly accompanied with acute and chronic complications. Up to date several different types of DM have been described each of which have different mechanisms in affecting and damaging the tissues. Today we know that high blood sugar leads to damage in tissues via vascular damage which reveals decreased vascular perfusion and eventually hypoxia. In this context, babies whom born to women who developed DM and associated chronic complications such as nephropathy, retinopathy before pregnancy, present different clinical picture than the babies whom born to women who develops DM during the pregnancy. It is known that, umbilical cord connective tissue (Wharton Jelly) was rich for mesenchymal stem cells. In the current study we studied on umbilical cord samples that were obtained from 7 pregnant women who had DM diagnosis and developed nephropathy complication before pregnancy (VK-PGDM), 7 pregnant women who developed DM during pregnancy (GDM) and 7 healthy pregnant women, respectively. These cords were evaluated under light microscope after staining with H-E, Masson Trichrome and PAS, respectively. Stem cells were isolated from Wharton Jelly via enzymatic digestion. Derived mesenchymal stem cells have been determined and counted by flow cytometry based on the (+) markers of CD73, CD90, CD105 and (-) markers of CD45 and CD34. Using the same markers, mesenchymal stem cells have also been stained with immunohistochemistry technique. Our analysis revealed increase of the diameter of the cord derived from GDM group while the diameter of the cord from VK-PGDM group were found to be decreased. We also identified significant thickening of the arterial walls in both GDM and VK-PGDM groups. Wharton Jelly mesenchymal cell number was found to be increased in GDM group and significantly decreased in VK-PGDM group. Key Words: Umbilical Cord, Wharton Jelly, Mesenchymal Stem Cell, Gestational Diabetes, Pre- Gestational Diabetes