Investigation of sFLT-1 and ADM proteinexpression levels on placentas of the gestational diabetes mellitus

Aim: In this study, we aimed to investigate the expression levels of adrenomedullin (ADM) and sFLT-1, two new proteins that have a role in vascular regulation in gestational diabetes mellitus, to compare the expression levels of these proteins in the histopathology of the disease, to correlate the expression intensity of these proteins with possibility of discovering as a protein marker. Materials And Methods: 20 normotensive and 20 GDM placenta samples were taken. Routine paraffin wax embedding tissue protocol was performed. Six µm sections were stained with Hematoxylin-Eosin, Periodic Acid Schiff (PAS). ADM and sFLT-1 antibodies were immunohistochemically incubated on sections. Results: In the GDM group, vascular dilatation and congestion in stem villus, hyperplasic endothelial cells, and increased syncytial bridges in the external part of the villi, mononuclear cell infiltration, pyknotic nuclei and cytoplasm loss in some of the desidual cells in the maternal region were observed. In immunohistochemical examination, cytotrophoblast and syncytiotrophoblast cells of villous and syncytial nodes showed negative ADM expression. ADM was positively expressed in some cytotrophoblast cells of small villi, vascular endothelial cells and desidual cells. In the GDM group, sFLT-1 expression was positive in endothelial cells, some Hoffbauer cells of mesenchymal connective tissue, desidual cell nuclei and membranes. Conclusion: ADM may be an important receptor in the insulin metabolism to determine the glucose level because we found positive ADM expression in cytotrophoblasts and membranes of desidual cells. In addition, changes in endothelial cells of maternal and fetal regions and sFLT-1 expression in Hoffbauer cells suggest that this molecule possibly play a key role in angiogenic effect. Keywords: Placenta, PAS, Hematoxylin-Eosin, GDM, sFLT-1, ADM