Alterações histopatológicas pancreáticas, placentárias e na matriz extracelular hipofisária durante a diabetes mellitus gestacional

Abstract

Gestational Diabetes Mellitus (GDM) can be defined as carbohidrat intolerance during pregnancy and it may affect 10-22% off all pregnant pacients. During pregnancy can surge lots of complications to the fetus such as high risk of spontaneous abortion, congenital abnormalities and neonatal morbity and mortality. However, it can also surge morphofunctional alterations in several organs of the diabetic mother, but it has not been well established .To investigate if there is going to be biochemical and histopathological alterations in several organs, such as pituitary, uterus, placenta and pancreas of pregnant diabetics rats during and in the end of pregnancy and compared them. Furthermore, to investigate if there is pituitary alteration of the extracellular matrix (ECM) in these animals. On the 5th day of life, Wistar rats were divided in two groups: one treated with streptozotocin (Diabetic Group/DIAB) , with the dose of 90 mg/kg, subcutaneous and another group , treated with vehicle (citrate buffer/CTR). At 90 days of life, they were mated . After, they were sacrified at 11o e 21o days of pregnancy. Were evaluated maternal glicemia and biochemistry and implant numbers. The pancreas, uterus,placenta e pituitary were stained with Hematoxilin and Eosin and only the pituitary were stained with Masson and Picrosirius, for ECM evaluation. Diabetic animals of 11o day as well as 21o days during pregnancy showed a reduced implant numbers, reduced weight and higher glicemia and total cholesterol , compared with control animals independent of pregnancy day. It was not verified difference in triglycerides levels between non diabetic and diabetic animals, independent of the day. However, diabetic animals that concluded the gestational period showed a higher maternal glicemia compared with 11o day diabetic group. Pancreas of 21o days diabetic animals showed islets intracitoplasmatic vacuolization, insulitis, inflammatory cell migration, thickness of wall vessel and periductal and vascular fibrosis. These alterations were verified in low intensity in 11o day diabetic animals. It was verified at the placenta of diabetic animal congestion in the interface maternal-fetal ,cell migration , higher concentration of maternal and fetal vessels , but in irregular shape , necrosis and vacuolization.The pituitary of diabetic animals showed chromophobs cells aggregation, stiffness of red collagen fibers of ECM , in contrast of control, that was visualized green ones and in bundle shape . Diabetes performed a total tissue remodeling in pituitary . Pancreas of diabetic pregnant animals showed a more damage pancreas and placenta, especially in the end of pregnancy.In consequence of these alterations,these diabetic animals presented hyperglycemia, higher total cholesterol , but low maternal weight , implant numbers and no changes in triglycerides. This study is the first to demonstrate that during experimental gestational diabetes occurs a tissue remodeling of some elements of ECM in pituitary, such as stiffness of ECM and presence of red collagen fibers. Control animals presented a thin ECM layer and green collagen fibers.Pituitary alterations in ECM probably are due diabetes process during pregnancy.