Gestational diabetes mellitus (GDM) has been associated with impaired maternal immune response. Our aim was to review the available literature linking immune cells profile to GDM, in order to comprehend the role that different subpopulations play in the development of this pathology. We searched in PubMed for studies published in the last decade on circulating levels and placenta expression of immune cells on GDM. We identified 18 studies with several differences regarding the study design, clinical characteristics, number of participants, cell subpopulation and type of sample. Most studies assessed only one subpopulation either in peripheral blood or placenta and did not analyse functional properties of the cells. The most frequently evaluated immune cells were T lymphocytes, especially regulatory T (Tregs), and natural killer (NK) cells in the peripheral blood, and placental macrophages. No studies analysing B cells were identified, and only one study each evaluating γδT cells, dendritic cell (DC) and monocytes was found. Although there are controversies, at least one study reported positive association between GDM and CD4⁺(activated), Tregs, Th17 and γδT cells; neutrophil/lymphocyte; NK cell (cytotoxic); macrophages; and monocytes. The number of studies is still small, so caution should be exercised in interpreting the data, and further research is required to validate these findings and establish the role of adaptive and innate immune cells in GDM pathophysiology.

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揭示妊娠糖尿病的病理生理学：局部和外周免疫细胞的研究

妊娠糖尿病（GDM）与母体免疫反应受损有关。我们的目的是回顾将免疫细胞谱与GDM相关的现有文献，以了解不同亚群在这种病理学发展中的作用。我们在PubMed中搜索了过去十年发表的关于GDM上免疫细胞的循环水平和胎盘表达的研究。我们确定了18项研究，这些研究在研究设计，临床特征，参与者人数，细胞亚群和样品类型方面存在若干差异。大多数研究仅评估了外周血或胎盘中的一个亚群，并且没有分析细胞的功能特性。评估最频繁的免疫细胞是T淋巴细胞，尤其是调节性T（Tregs），以及外周血和胎盘巨噬细胞中的自然杀伤（NK）细胞。没有发现分析B细胞的研究，仅发现一项评估γδT细胞，树突状细胞（DC）和单核细胞的研究。尽管存在争议，但至少有一项研究报道了GDM和CD4之间存在正相关⁺（激活），Tregs，Th17和γδT细胞；中性粒细胞/淋巴细胞；NK细胞（细胞毒性）；巨噬细胞 和单核细胞。研究的数量仍然很少，因此在解释数据时应谨慎行事，需要进一步的研究以验证这些发现并确定适应性和天然免疫细胞在GDM病理生理学中的作用。