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目的探讨葡萄糖调节蛋白78(GRP78)和半胱氨酸天冬氨酸蛋白酶12(Caspase-12)m RNA在妊娠期糖尿病(GDM)孕妇胎盘组织滋养细胞中的相对表达水平。方法选取2014年1月-2015年12月于南通市第一人民医院行常规产检至分娩的65例孕妇并分为GDM组(35例)和正常妊娠组(30例)。收集并处理胎盘标本,用透视电镜观察内质网超微结构的变化,并采用实时荧光PCR技术检测GRP78和Caspase-12 m RNA在胎盘组织滋养细胞中的相对表达水平。结果正常妊娠组孕妇胎盘组织中滋养细胞内含有丰富的内质网,形态规整,无扩张及肿胀。GDM组孕妇胎盘组织中滋养细胞内质网脱颗粒,明显扩张及肿胀,甚至部分融合。GDM组及正常妊娠组孕妇胎盘组织滋养细胞中GRP78 m RNA相对表达水平分别为(4.70±1.35)和(2.54±0.85),两组比较差异有统计学意义(t=3.835,P<0.05)。GDM组及正常妊娠组孕妇胎盘组织滋养细胞中Caspase-12m RNA相对表达水平分别为(5.50±1.54)和(3.00±0.95),两组比较差异有统计学意义(t=4.717,P<0.05)。结论内质网应激介导的胎盘滋养细胞凋亡与GDM密切相关,可能是导致不良妊娠结局的重要机制。
Objective To investigate the relative expression levels of GRP78 and Caspase-12 mRNA in gestational diabetes mellitus (gestational trophoblast) placenta from pregnant women. Methods From January 2014 to December 2015, 65 pregnant women who were routinely given birth to delivery in Nantong First People’s Hospital were divided into GDM group (n = 35) and normal pregnancy group (n = 30). Placenta samples were collected and processed. The ultrastructure of endoplasmic reticulum was observed by electron microscope. The relative expression of GRP78 and Caspase-12 mRNA in placental trophoblast cells was detected by real-time fluorescence PCR. Results In the normal pregnancy group, the placental tissue of pregnant women contained abundant endoplasmic reticulum in the trophoblast, with regular shape and no expansion and swelling. GDM group placenta of pregnant women trophoblast endoplasmic reticulum degranulation, significant expansion and swelling, and even partial fusion. The relative expression levels of GRP78 m RNA in placental trophoblast of pregnant women in GDM group and normal pregnancy group were (4.70 ± 1.35) and (2.54 ± 0.85) respectively, with significant difference between the two groups (t = 3.835, P <0.05). The relative expression levels of Caspase-12mRNA in placental trophoblast of pregnant women in GDM group and normal pregnancy group were (5.50 ± 1.54) and (3.00 ± 0.95) respectively, with significant difference between the two groups (t = 4.717, P <0.05) . Conclusion Endoplasmic reticulum stress-mediated apoptosis of placental trophoblast cells is closely related to GDM, which may be an important mechanism leading to adverse pregnancy outcomes.