However, this relationship changed dependent

upon the amount of periodontal disease and the amount of antibody to pathogens. Somewhat counterintuitively, in patients with more generalized periodontitis or having the highest level of antibody to the pathogens, the correlation in antibody levels to the pathogens and commensals were minimal. This finding supports the hypothesis that with chronic infection leading to oral tissue destruction, the host immune response RG-7388 concentration is dysregulated and selectively recognizes and responds to the pathogens, while not responding as robustly to the multitude of commensal bacteria within the context of the large polymicrobial ecology [7,30,37]. We did, however, observe a significant correlation between antibody levels to P. gingivalis and periodontal Pifithrin-�� order status. These relationships were noted in blacks and males within this population of smoking patients and correlated specifically with the frequency of disease sites, linking the antibody more directly to the infectious challenge. In summary, the data show an elevated immune response to pathogens compared to commensals within this smoking population and suggesting that the host immune system has the ability to discriminate between potential pathogenic versus commensal species in the complex biofilms. Response to the pathogens was also shown to be greatest in the subjects with the greatest extent

of disease, comparable to previous findings in other populations and was most notable with antibody to P. gingivalis[21,38]. Clomifene The observation that black males demonstrated the most severe periodontal disease, which was not commensurate with their level of smoking, supports the need for additional studies to identify the factor(s) that could be contributing to disease susceptibility/expression. While we acknowledge that this was not an exhaustive study of antibody specificities to oral bacterial, the findings highlight processes by which the immune system

recognizes pathogens such as P. gingivalis, and this response would be predicted to help to manage the periodontal disease immunopathology in adult populations. As importantly, it must be considered that antibodies are effector molecules in the host immune response and principal protective factors against extracellular bacterial pathogens. In that regard, previous studies have described antibody subclass distribution to oral pathogens [25,39,40] and suggested variations in the profiles related to the particular bacterial species. These findings were extended to potential success or failure of the antibodies to protect the host effectively. A range of studies have suggested that the immune response to oral pathogens does not mature effectively, as estimated via antibody avidity [41–46], and could contribute to lowered protective capacity. Furthermore, examination of the effector functions of antibodies to the oral pathogens has provided some challenge due to, for example, the gingipains from P.

Values are given as 2−delta

CT. RORγt primer (Metabion, Planegg-Martinsried, Germany) and probes were obtained from Eurogentec (Cologne, Germany) using the previously described sequences [70]. t-bet and PNOC panel were purchased from Applied Biosystems (Foster City, CA, USA) with the numbers Mm00450960_m1 and Mm00803087_m1. To analyse cytokine release during aTreg restimulation, selleck chemical supernatants were collected and stored at –80°C. Cytokine content was quantified using the CBA kit (FlowCytomix) from Bender MedSystems® (Vienna, Austria). The supernatants were prepared according to the manufacture’s protocol. Samples were analysed on a FACSCalibur (Becton Dickinson, San Jose, USA). To determine the frequency of Treg cells, cells were stained for CD3ε-PerCP (clone

145–2C11, Biolegend Fell, Germany), CD25-PE (clone 3C7, Miltenyi® Biotec) and Foxp3-FITC Wnt inhibitor (clone FJK-16, eBioscience). The cells were first stained for the surface expression of CD3ε and CD25 for 15 min at 4°C. Cells were then washed, fixed and permeabilised (30 min; 4°C) using the buffer from the Foxp3 staining kit (eBioscience) followed by an intracellular staining for Foxp3 and/or Helios-AlexaFluor 647 (clone 22F6, Biolegend Fell, Germany) for 30 min at 4°C. The percentage of CD4+CD25+Foxp3+ Treg cells was determined on a FACSCalibur (BD). The maturation of B cells was measured using CD19-FITC (clone 6D5, Miltenyi® Biotec), IAb–PE (clone M5/ 114.15.2, eBioscience) and CD86-Biotin (clone GL-1)/Streptavidin-PerCP (both Biolegend, Fell, Germany). Data were analysed with CellQuest software. For intracellular cytokine staining, cells were harvested after 7 days of primary culture washed once and restimulated with 1 μg/mL ionomycin and 10 ng/mL phorbol myristate acetate (both Biotrend Chemikalien GmbH, Cologne, Germany) for 4 h at 37°C. After 2 h, 2 μg/mL Brefeldin A (Sigma-Aldrich Chemie

GmbH, Steinheim, Germany) was added to imbed the cytokines inside the cells. Subsequently, cells were labelled with the live/dead stain (Fixable Viability Dye eFluor 506, eBioscience), their surface expression of CD3ε and CD25 (15 min; 4°C), and additionally fixed and Sclareol permeabilised with the Foxp3 staining kit. Intracellular staining for IFN-γ allophycocyanin (clone XMG1.2, Biolegend), IL-17-FITC (clone ebio17B7, eBioscience) and Foxp3– Alexa Fluor 488 (FJK-16s, eBioscience) was done for 30 min. Samples were measured by LSR II (BD) and analysed with FlowJo software (Treestare, Ashland, OR, USA). Neuropilin-1 was stained on the surface of the cells using Neuropiln-1-PerCP (R&D Systems) CD40L staining was done as described by Kirchhoff et al. [71]. aTreg cells were isolated from primary culture and restimulated with allogeneic B cells. To prevent exportation and degradation of CD40L, we added 5 μg/mL Brefeldin A after 2 h of stimulation. The next day CD40L (PE, R&D Systems) was stained intracellularly using the Foxp3 staining kit.

Clinical scores were analysed using the non-parametric Mann–Whitney U-test. The level of significance was set at P < 0·05. EAE was induced in C57BL/6 mice by immunization with the MOG35–55 peptide in CFA followed by i.v. injection of PT. EAE mice exhibited three disease phases: preclinical, peak and remission phases. Sorafenib datasheet Clinical signs (partial limp tail) presented at 7 dpi. Disease

then progressed to limp tail, waddling gait and paralysis during the peak phases (at 16 dpi). Finally, mice recovered but still presented with clinical signs during the remission phases (at 28 dpi). CFA mice showed no clinical signs at all (Fig. 1a). Lymph node MNCs were isolated from 7 dpi EAE and CFA mice and then co-cultured with astrocytes at lymphocyte : astrocyte ratios of 10:1, 1:1, and 1:5. At the lymphocyte : astrocyte ratios tested there were no differences in proliferation among cells isolated from the CFA group, with the exception of CD3/CD28 and concanavalin A (ConA)-stimulated cells (Fig. 1b). Conversely, lymphocytes isolated

from EAE mice proliferated significantly in response to stimulation with MOG35–55 peptide (P < 0·001). In the EAE lymphocyte : astrocyte co-cultured group, lymphocyte proliferation was inhibited by half at a ratio of 10:1 (P < 0·01) and inhibited completely at ratios of 1:1 and 1:5 (P < 0·001) compared to proliferation observed for MOG35–55 peptide-stimulated EAE lymphocytes alone. These data indicate that the inhibitory effect of astrocytes on MOG35–55-specific lymphocytes is correlated with lymphocyte : astrocyte ratios. Lymphocytes were then co-cultured with astrocytes BAY 80-6946 chemical structure at a lymphocyte : astrocyte Edoxaban ratio of 10 : 1. Supernatants were obtained 72 h later and cytokine levels were detected by ELISA. In the supernatants collected from EAE lymphocyte : astrocyte cultures, IFN-γ (P < 0·001) and IL-17 (P < 0·001) levels were decreased significantly; IL-4 and TGF-β levels were also decreased compared to levels observed for EAE lymphocytes. There were no significant differences in cytokine production by cells harvested from mice

in the CFA groups. Levels of the above cytokines were lower in the supernatants of astrocytes cultured alone (Fig. 1c). The suppressing effect of astrocyte on MOG35–55-specific lymphocytes might be mediated by soluble factors as well as cell contact. We cultured astrocyte and MOG35–55-specific lymphocytes without contact between both cells using Transwell plates. Supernatants were taken out to test cytokine levels after 72 h. Results are shown in Fig. 1d. Significant reductions of IFN-γ (P < 0·001) and IL-17 (P < 0·001) levels were also observed at the co-culture group without contact between both cells. These results suggest that cell contact is not required in astrocyte-mediated suppression of lymphocyte secreting, and might be mediated by soluble factors. Astrocytes were incubated in the presence or absence of IFN-γ and then co-cultured with lymphocytes for 72 h.

The overlap of these miRNAs in the blood of UC and CD patients suggests a generalized inflammatory status common to both

diseases as well as other autoimmune diseases. The first papers published on miRNA expression patterns in IBD patients were performed in tissue samples [22-25]. We Buparlisib mw have found seven miRNAs expressed specifically in the mucosa of aCD. None of these miRNAs have been described previously in the mucosa of aCD patients. One tissue miRNA of aCD, miR-140-3p, coincided with one of the miRNAs expressed exclusively in the blood of CD patients (aCD and iCD together). Previous studies have demonstrated that miR-140-3p was down-regulated in tumour samples of colorectal cancer [42] and could regulate the expression of a membrane protein (CD38) through the activation of TNF-α and NF-κB [43]. We believe that miR-140-3p should be explored specifically in the blood of aCD to gain an understanding of its role in the pathogenesis of CD and to confirm the mucosa and serum correlation. We hypothesized that miR-140-3p could be used as a biomarker of active disease. In contrast to the serum findings, we found five tissue miRNAs that were able to distinguish aUC from iUC. None of these tissue miRNAs have been described previously for aUC patients. In contrast, Fasseu et al. described

a decreased expression of miR-196b in the mucosa of Dasatinib molecular weight iUC patients [23]. None of the mucosa miRNAs found exclusively in aUC coincided with mucosa miRNAs in aCD, which suggests the possibility of using tissue miRNAs expression patterns to distinguish both pathologies. The available evidence indicates that miRNA expression in plasma and serum appears to reflect the extrusion of miRNAs from distant tissues or organs or disease pathways [11-13, 20]. In this regard, the results of Wu et al. did not identify

the same expression patterns in mucosa and peripheral blood. Metalloexopeptidase They hypothesized that the peripheral blood miRNAs of their study possibly identified the expression in circulating white blood cells [19]. Our results do not show an exact correlation between the miRNA expression profiles of the serum and mucosa of the same patients. We believe that this dissimilarity may be because of the small number of patients, who were extremely heterogeneous, and the treatments employed during the disease could cause epigenetic changes with an impact on the miRNA expression profiles. Nevertheless, we have shown throughout the discussion that some of our serum miRNAs have been found previously in the mucosa under the same conditions. The most surprising finding was that miR-127-3p was shown to be the miRNA with increased expression in both UC and CD patients. Similar to our findings, Fasseu et al.

From December 2009 to August 2012,

we used this ALT chimeric flap to reconstruct two separate defects in upper extremity on five patients (mean age: 36.6 years; range: 15∼47 years). The locations of defect were PLX4032 molecular weight palm and fingers in four patients and forearm in the other patient. The sizes of defect ranged from 4.5 × 1.5 cm to 20 × 10 cm. A minimum of two separate perforator vessels in the flap were identified. The skin paddle was then split between the two perforators to shape two separate paddles with a common vascular supply. There were no cases of flap failure or re-exploration. Four donor sites were directly closed and one was covered by a skin graft. Donor-site morbidity was negligible. The ALT chimeric flap provides customized cover for two separate defects in upper extremity. © 2013 Wiley Periodicals, Inc. Microsurgery 33:631–637, 2013. “
“Elbow reconstruction is challenging for reconstructive surgeons. The purpose of this report is to present the results of the use of freestyle perforator-based propeller flap designed from the medial arm region Selleckchem C59 wnt for elbow reconstruction. The defects following soft tissue sarcoma resection at the medial and posterior elbow were repaired in

two patients. The dimensions of the defects were 11 × 7 cm2 and 10 × 7 cm2. Two perforators were identified in each case using Doppler ultrasound probe in the medial arm, adjacent to the defect. The perforator with visible pulsation was chosen as the pedicle vessel, which was 12-cm and 7-cm proximal to the medial epicondyle. An elliptical flap, extending almost the full length of arm, was raised

and rotated 180° to repair medial elbow defects. The sizes of the flaps were 17 × 8 cm2 and 11 × 7 cm2. The donor sites were closed directly. Both flaps survived; temporary out venous congestion occurred in one case. There were no other postoperative complications. These cases illustrated that the medial arm flap might be used for reconstruction of medial elbow defects with this freestyle perforator-based propeller flap design. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“Skin graft is still a method of choice for the coverage of temporal defects. But there are some disadvantages like a “patch” appearance, the need of dressing or longer healing time. Numbers of local flaps have been described for closing skin defects on temporal region. Yet, they may cause distortion of the surrounding tissues, especially in the temporal hairline and eyebrow. We present a series of seven local flaps based on small branches (SB) of the superficial temporal artery (STA) for the coverage of temporal defects, and discuss their advantages. Supermicrodissection of SB of the STA was performed to obtain local flaps for reconstruction of temporal defects after skin cancer excisions in seven patients.

These results point to the role of reduced oxygenation to the pathogenesis of inflammatory disorders and/or autoimmune diseases, which are associated with over-expression of some of these receptors [26, 33, 43]. The influence of low pO2 on the expression profile of immune-related surface receptors has been previously documented in other monocytic lineage cells, such as primary monocytes exposed to short-term hypoxia [36] and monocyte-derived mDCs generated under long-term hypoxic MDV3100 in vivo conditions [18, 23], and the results reported here extend to iDCs this trend of response to hypoxia. However, different combinations

of receptor-encoding genes are expressed in these cell populations, suggesting that hypoxia may activate a specific transcriptional response in MP depending on their differentiation/maturation stage, which probably represents a mechanism of regulation of the amplitude and duration of inflammatory responses, and the challenge of future studies will be to validate these data in vivo. TREM-1 is one of the few hypoxia-inducible gene targets in H-iDCs shared

with H-mDCs and monocytes. TREM-1 mRNA expression is consistently expressed on H-iDCs generated from different Abiraterone ic50 donors but not on the normoxic counterpart, confirming previous evidence of TREM-1 downregulation during monocyte to iDCs differentiation under normoxic conditions [28, 30]. mRNA induction is paralleled by expression of the membrane-bound receptor and its soluble form, detectable in several inflammatory disorders [29, 37, 44]. TREM-1 inducibility by hypoxia is reversible, because cell reoxygenation

results in marked decrease of the receptor supporting the role of low pO2 as a TREM-1 inducer in iDCs. In line with these findings, we provide Demeclocycline evidence that the HIF/HRE system is implicated, at least in part, in TREM-1 gene inducibility by hypoxia. H-iDCs treatment with echinomycin, a known specific inhibitor of HIF-1 binding to HRE and transcriptional activity [39], downmodulates TREM-1 mRNA and surface protein levels. The potential contribution of other transcription factors, known to mediate hypoxia-dependent gene transactivation in myeloid cells [11, 17, 45], to the regulation of TREM-1 expression in H-iDCs is currently under investigation. These results suggest that TREM-1 expression in iDCs in vivo may vary dynamically with the degree of local tissue oxygenation, which is quite heterogeneous and rapidly fluctuating in diseased tissues [24], giving rise to distinct DC subsets potentially endowed with different functional properties TREM-1 is functionally active in H-iDCs, as demonstrated by the finding that TREM-1 cross-linking by an agonist mAb on H-iDCs increases surface expression of CXCR4 and CD86 and promotes that of CCR7 and CD83, which play a central role in T-cell migration and activation [46].

This NKT cell migration in vivo is arrested in liver sinusoids upon encounter with antigen presented on sinusoidal epithelial cells within minutes after injection of αGalCer.[64, Erismodegib 41, 65-67] In addition to antigen,

the IL-12 and IL-18 pro-inflammatory cytokines also terminate type I NKT cell motility in liver sinusoids of Cxcr6gfp/+ mice in a CD1d-independent manner. The latter arrest in NKT cell movement occurs by 1 hr after exposure to the cytokines and precedes NKT cell activation. Subsequent antigen encounter stabilizes the formation of an immune synapse between NKT cells and interacting APCs. This synapse elicits lymphocyte function-associated-1/intercellular adhesion molecule-1 interactions that enable activated type I NKT cells to be retained in the liver, demonstrating that activated type I NKT cells recirculate less than activated conventional CD4+ T cells.[68] However, after a stroke, type I NKT cells rapidly exit the liver and elicit bacteraemia. Similarly, NKT cells extravasate rapidly from the lung of αGalCer-treated mice and trigger inflammation and adaptive immune responses.[69] Hence, the patterns and kinetics of recirculation of type I mouse NKT cells differ in a tissue- and stimulus-dependent manner. Additional studies are required to unravel the mechanisms involved

and to determine whether this variation in recirculation exists for mouse type II NKT cells and human type I and type II NKT cells. Humans possess both CD4+ and CD4− type I NKT cells.[11] Although both subsets secrete Th1-type cytokines, selleck chemicals llc CD4+ type I NKT cells secrete predominantly Th2-type cytokines. In a population of Th1-like CD4− NKT cells, CD8α+ cells comprise a large subset and CD8αβ+ cells a small subset. CD8α+ typeΙΝΚΤ cells secrete more IFN-γ and possess greater cytotoxic activity than do CD4+ or CD4− NKT cells. In human peripheral blood, type I NKT cells comprise about 0·1–0·2% of T cells, but this proportion is highly variable and can range

from < 0·1% to > 2%.[70-72] Twin studies suggest that the number of human type I NKT cells in PBMCs is genetically regulated.[4] Interestingly, human type I NKT cells are enriched in second the omentum (about 10% of T cells) and not in the liver.[73, 74] Reduced numbers of type I NKT cells in PBMCs appear to correlate with several autoimmune or inflammatory conditions and cancers,[75] but this finding remains controversial. Similarly in patients with rheumatoid arthritis, PBMCs[76, 77] and synovia[78] display lower levels of NKT cells as well as a Th1 bias during disease.[77] Interestingly, patients with myasthenia gravis display elevated levels of type I NKT cells in PBMCs, in contrast to those in PBMCs from patients with MS,[75] rheumatoid arthritis[76] and type 1 diabetes[79]. The reason for these differences is currently unknown. Nevertheless, NKT cell levels return to normal levels after treatment.

On the other hand, downregulation of IRF4 might dampen exaggerated responses during autoimmunity. Future studies further investigating

the molecular actions of IRF4 may facilitate the development of such strategies and their employment in therapeutic settings. This work was supported by Deutsche Forschungsgemeinschaft, grants HU 1824/2-1 and SFB/TR22 to M.L. The authors declare no financial or commercial conflict of interest. “
“Ly49G2 (G2+) NK cells mediate murine (M)CMV resistance in MHC Dk-expressing mice. Bone marrow transplantation (BMT) studies revealed that G2+ NK cell-mediated MCMV resistance requires Dk in both hematopoietic and nonhematopoietic cells. As a Ly49G2 ligand, Dk in both cell lineages may contribute to lysis of virus-infected cells. Alternatively, Maraviroc datasheet cellular differences in self-MHC Dk may have affected NK-cell education, and consequently NK cell-mediated viral clearance. We investigated the Dk-licensing effect on BM-derived NK cells in BMT recipients by analyzing cytokines, cytotoxicity and MCMV resistance.

In BMT recipients with lineage-restricted Dk, G2+ NK-cell reactivity and cytotoxicity was diminished in comparison to BMT recipients with self-MHC in all cells. Reduced G2+ NK-mediated MCMV resistance in BMT recipients with lineage-restricted self-MHC indicates that licensing of G2+ NK cells is related to NK-cell reactivity selleck products and viral control. Titrating donor BM with self-MHC-bearing hematopoietic cells, as well as adoptive transfer of mature G2+ NK cells into BMT recipients with self-MHC

in non-hematopoietic cells only, enhanced NK-cell licensing and rescued MCMV resistance. This disparate self-MHC NK-cell education model would suggest that inadequately licensed NK cells corresponded to inefficient viral sensing and clearance. “
“Colitis is still before a significant disease challenge in humans, but its underlying mechanism remains to be fully elucidated. The transient receptor potential vanilloid (TRPV) ion channel plays an important pathological role in host immunity, as deficiency of TRPV compromises host defence in vivo and in vitro. Using a DSS-induced colitis mouse model, the function of TRPV2 in the development of colitis was investigated, utilizing TRPV2−/− and Wt mice. Less severe colitis was observed in TRPV2−/−, compared to that of Wt mice, at the clinical, histopathological and immunohistochemical levels. Compared to Wt mice, reduced severity of colitis in TRPV2−/− mice may be due to less intestinal inflammation via reduced recruitment of macrophages. The TRPV2 pathway contributes to the development of colitis. These data provide useful information for potential therapeutic intervention in colitis patients. “
“Bcl11b is a transcription factor that, within the hematopoietic system, is expressed specifically in T cells.

In TECs, HG stimulation increased pro-inflammatory/Th1/Th2 gene expression. Phosphorylation of signaling proteins shifted towards pro-inflammatory phenotype with suppressed phosphorylation of Th2 related signaling in TECs. Conclusion: These results suggest that pro-inflammatory axis induced by HG may play a role in the STI571 progression of diabetic nephropathy. JIN HUA, PIAO SHANG GUO, JIN JI ZHE, ZHENG HAI LAN, LI CAN YanBian University Hospital Introduction: Leflunomide

(LEF) and benazepril have renoprotective effects on diabetic nephropathy (DN) through their anti-inflammatory and anti-fibrotic activities. This study investigated whether combined treatment using LEF and benazepril affords superior protection compared with the respective monotherapies. Methods: Diabetes was induced with streptozotocin (STZ, 65 mg/kg) by intraperitoneal injection in male Wistar rats. Two weeks after STZ injection, diabetic rats were treated daily for 12 weeks with LEF (10 mg/kg), benazepril (10 mg/kg), or a combination of LEF and benazepril. Basic parameters Ruxolitinib purchase (body weight, fasting blood glucose level, and 24 h urinary protein excretion), histopathology, inflammatory (monocyte chemoattractant protein-1 [MCP-1] and Toll-like

receptor-2 [TLR-2]) and glomerulosclerotic factors (Transforming growth factor-beta1 [TGF-β1] and connective tissue growth factor [CTGF]), and oxidative stress (8-hydroxy-2¢-deoxyguanosine, 8-OHdG) were studied. Results: Benazepril or LEF treatment significantly prevented body weight loss and 24 h urinary protein excretion induced by diabetes; combined treatment with LEF and benazepril further improved these parameters compared with giving each drug alone (all P < 0.01).

Increased expression of inflammatory (MCP-1 and TLR-2) and glomerulosclerotic (TGF-β1 and CTGF) factors in diabetic rat kidney was reduced by treatment with either EGFR inhibitor LEF or benazepril and was further reduced by the combined administration of the two drugs (P < 0.01). These effects were accompanied by suppression of urinary 8-OHdG excretion. There was no significant between-group difference in blood glucose level. Conclusion: LEF treatment lessens DN, and combined treatment with LEF and benazepril provided synergistic effects in preventing DN. HAGIWARA SHINJI1,2, MCCLELLAND AARON1, COOPER MARK1, TOMINO YASUHIKO2, PHILLIP KANTHARIDIS PHILLIP1 1JDRF Danielle Alberti Memorial Centre for Diabetes Complications, Diabetes Division, Baker IDI Heart and Diabetes Institute; 2Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine Introduction: MicroRNAs (miRNAs) are a novel class of non-coding RNA that regulate gene expression post-transcriptionally by cleavage or translational repression of specific target mRNAs.

As for adenosine effects on l-arginine/NO pathway, there are no reports addressing the potential effects of selleck screening library insulin on this signaling

pathway in the human placental microvasculature from either normal or GDM pregnancies [39, 81]. Insulin was shown to revers the GDM-associated reduced uptake of adenosine via hENT2, rather than hENT1 in hPMEC primary cultures [71]. In these cells, the insulin effect was paralleled by normalization of extracellular adenosine concentration due to restoration of SLC29A2 promoter activity. This phenomenon was mediated by an increase in the IR-A, but a reduction in the IR-B mRNA expression to values in cells from normal pregnancies. Furthermore, IR-A and IR-B associated preferential cell signaling mechanisms (i.e.,

p42/44mapk or Akt, respectively) were also restored by insulin in this cell type. Thus, since insulin restores GDM-associated increase in l-arginine transport to values in cells from normal pregnancies, it is likely that the beneficial effect of this hormone results from normalization of extracellular levels of adenosine due to restoration of hENT2 expression and ICG-001 chemical structure activity in this cell type. GDM is a disease that alters the normal function of the micro- and macrovascular endothelium in the human placenta, a phenomenon that is due to increased expression and activity of l-arginine membrane transporters hCATs (likely hCAT1 and/or hCAT2-B) and NOS (likely eNOS) in this cell type. Adenosine, as a potent vasodilator in most of the vascular beds [16, 81], sustains this effect of GDM by activating adenosine receptors (likely A2BAR). Insulin plays a crucial function in the modulation of l-arginine transport in HUVEC and hPMEC from GDM pregnancies since many this hormone restores the increased l-arginine transport in these cell types via mechanism that could potentially involve IR-A and IR-B subtype, and p42/44mapk and Akt signaling pathways, respectively. In addition, hENT1 and hENT2,

but only hENT2 expression and activity are apparently under modulation by insulin in HUVEC and hPMEC, respectively. This is complementary to the key role of this type of nucleoside transporters in placental endothelial cells from pregnancies coursing with GDM or other diseases [39, 81]. We suggest that the described phenomena in the micro- and macrovascular endothelium from the human placenta establish a clearer functional link between adenosine transport/receptors and insulin receptors (i.e., adenosine/insulin axis) in these cell types. The described mechanisms could in part explain the increased plasma adenosine concentrations detected in the fetal blood from GDM pregnancies and could be a tool to be considered a potential therapeutic approach for the treatment of this disease as recently proposed by us [40, 39, 81] and other groups [16]. GDM is a disease that associates with disturbances in the function of the human placental vasculature mainly due to endothelial dysfunction.