Examinando por Autor "Grismaldo, Adriana"
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Ítem Exposome and foetoplacental vascular dysfunction in gestational diabetes mellitus(Elsevier, 2021) Valero, Paola; Fuentes, Gonzalo; Cornejo, Marcelo; Vega, Sofía; Grismaldo, Adriana; Pardo, Fabian; García-Rivas, Gerardo; Hillebrands, Jan-Luuk; Faas, Marijke M.; Casanello, Paola; Beek, Eline M. Van Der; Goor, Harry Van; Sobrevia, LuisA balanced communication between the mother, placenta and foetus is crucial to reach a successful pregnancy. Several windows of exposure to environmental toxins are present during pregnancy. When the women metabolic status is affected by a disease or environmental toxin, the foetus is impacted and may result in altered development and growth. Gestational diabetes mellitus (GDM) is a disease of pregnancy characterised by abnormal glucose metabolism affecting the mother and foetus. This disease of pregnancy associates with postnatal consequences for the child and the mother. The whole endogenous and exogenous environmental factors is defined as the exposome. Endogenous insults conform to the endo-exposome, and disruptors contained in the immediate environment are the ectoexposome. Some components of the endo-exposome, such as Selenium, vitamins D and B12, adenosine, and a high-fat diet, and ecto-exposome, such as the heavy metals Arsenic, Mercury, Lead and Copper, and per- and polyfluoroakyl substances, result in adverse pregnancies, including an elevated risk of GDM or gestational diabesity. The impact of the exposome on the human placenta’s vascular physiology and function in GDM and gestational diabesity is reviewed.Ítem Gestational diabesity and foetoplacental vascular dysfunction(Wiley, 2021) Cornejo, Marcelo; Fuentes, Gonzalo; Valero, Paola; Vega, Sofía; Grismaldo, Adriana; Toledo, Fernando; Pardo, Fabián; Moore-Carrasco, Rodrigo; Subiabre, Mario; Casanello, Paola; Faas, Marijke M.; Van Goor, Harry; Sobrevia, LuisGestational diabetes mellitus (GDM) shows a deficiency in the metabolism of D-glucose and other nutrients, thereby negatively affecting the foetoplacental vascular endothelium. Maternal hyperglycaemia and hyperinsulinemia play an important role in the aetiology of GDM. A combination of these and other factors predisposes women to developing GDM with pre-pregnancy normal weight, viz. classic GDM. However, women with GDM and prepregnancy obesity (gestational diabesity, GDty) or overweight (GDMow) show a different metabolic status than women with classic GDM. GDty and GDMow are associated with altered l-arginine/nitric oxide and insulin/adenosine axis signalling in the human foetoplacental microvascular and macrovascular endothelium. These alterations differ from those observed in classic GDM. Here, we have reviewed the consequences of GDty and GDMow in the modulation of foetoplacental endothelial cell function, highlighting studies describing the modulation of intracellular pH homeostasis and the potential implications of NO generation and adenosine signalling in GDty-associated foetal vascular insulin resistance. Moreover, with an increase in the rate of obesity in women of childbearing age worldwide, the prevalence of GDty is expected to increase in the next decades. Therefore, we emphasize that women with GDty and GDMow should be characterized with a different metabolic state from that of women with classic GDM to develop a more specific therapeutic approach for protecting the mother and foetus.