Investigation of adhesion molecules in the placentas of patients with Gestational Diabetes Mellitus with premature rupture of membranes

Aim: The aim of this study was to examine the expression rates of VCAM-1 and ICAM-1 in the placentas of patients with Gestational Diabetes Mellitus (GDM) and premature rupture of membranes (EMR) and to investigate their potential as biomarkers for the diagnosis and prognosis of these diseases. Materials and Methods: Placentas of 21 GDM+EMR and 21 healthy pregnant women were sectioned into 4-6 μm sections and stained with Hematoxylin-Eosin. Immunohistochemically, VCAM-1 and ICAM-1 antibodies were studied. Results: In GDM+EMR group, fibrinoid deposition, degeneration of chorionic villi and irregularities in villus structure, congestion and dilatation of capillary vessels were observed. Leukocyte infiltration was observed in the intervillous area. Desidua cells showed degeneration and pycnosis. Rupture of the amniotic membrane was observed. ICAM-1 immunostaining of placental sections of the GDM+EMR group showed intense ICAM-1 expression compared to the control group. ICAM-1 expression was positive in all placental components. ICAM-1 expression was positive in syncytiotrophoblast cells, cytotrophoblast cells, syncytial nodes, connective tissue and capillary endothelium. VCAM-1 immunostaining of placental sections of GDM+EMR group showed an increase in VCAM-1 immune reaction compared to the control group. Expression intensity increased in the trophoblastic layer of villi, syncytial nodes, fibrin deposition and villous connective tissue. Positive VCAM-1 expression was also seen in vascular endothelial cells. Conclusion: We have demonstrated that GDM+EMR leads to severe pathologic changes in placental structures and is associated with inflammatory and vascular dysfunction. Increased expression of ICAM-1 and VCAM-1 was considered as an indicator of this inflammatory process. Clinically, these findings may contribute to our understanding of the adverse effects of placental abnormalities associated with GDM and EMR on perinatal outcomes. In particular, the increase in adhesion molecules such as ICAM-1 and VCAM-1 suggests that they may be used as potential biomarkers in the prognosis and management of these diseases. Keywords: Gestational diabetes mellitus, premature rupture of membranes, adhesion molecules, VCAM-1, ICAM-1