{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:33:56Z","timestamp":1787027636707,"version":"build-2736575974"},"reference-count":116,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82570971, 82170854, 81870579, 81870545"],"award-info":[{"award-number":["82570971, 82170854, 81870579, 81870545"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"award":["82570971, 82170854, 81870579, 81870545"],"award-info":[{"award-number":["82570971, 82170854, 81870579, 81870545"]}],"id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Capital\u2019s Funds for Health Improvement and Research","award":["2026-1-4011"],"award-info":[{"award-number":["2026-1-4011"]}]},{"name":"Science and Technology Research Project of China Science and Technology Development Center for Chinese Medicine","award":["CXZH2024059"],"award-info":[{"award-number":["CXZH2024059"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2025-PUMCH-C-021, 2022-PUMCH-C-019"],"award-info":[{"award-number":["2025-PUMCH-C-021, 2022-PUMCH-C-019"]}]},{"name":"Peking Union Medical College Hospital Talent Cultivation Program","award":["Category C, UBJ06088"],"award-info":[{"award-number":["Category C, UBJ06088"]}]},{"award":["Category C, UBJ06088"],"award-info":[{"award-number":["Category C, UBJ06088"]}],"id":[{"id":"https:\/\/ror.org\/04jztag35","id-type":"ROR","asserted-by":"publisher"}]},{"name":"the Fundamental Research Funds for the Central Universities, Peking Union Medical College","award":["3332025117, 3332024127"],"award-info":[{"award-number":["3332025117, 3332024127"]}]},{"award":["3332025117, 3332024127"],"award-info":[{"award-number":["3332025117, 3332024127"]}],"id":[{"id":"https:\/\/ror.org\/02drdmm93","id-type":"ROR","asserted-by":"publisher"}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["CIFMS2021-1-I2M-002"],"award-info":[{"award-number":["CIFMS2021-1-I2M-002"]}]},{"name":"the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences","award":["2023-PT320-10"],"award-info":[{"award-number":["2023-PT320-10"]}]},{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["7202163"],"award-info":[{"award-number":["7202163"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"publisher","award":["Z201100005520011"],"award-info":[{"award-number":["Z201100005520011"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]},{"award":["Z201100005520011"],"award-info":[{"award-number":["Z201100005520011"]}],"id":[{"id":"https:\/\/ror.org\/034k14f91","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Placenta-derived extracellular vesicles (EVs), particularly exosomes, serve as key mediators that influence metabolic programming in offspring under adverse early nutritional conditions, such as maternal obesity or gestational diabetes. They respond to maternal nutritional disturbances\u2014such as obesity or gestational diabetes\u2014by altering the composition of the miRNAs and proteins they carry. Evidence from in vivo and in vitro studies suggests that these modified EVs influence offspring metabolic programming through multiple putative pathways: regulating fetal pancreatic \u03b2-cell development and function, modulating lipogenesis via PPAR\u03b3 signaling, affecting placental angiogenesis, and promoting inflammation and epigenetic alterations. By transmitting maternal environmental signals to the fetus, placental EVs are hypothesized to contribute to long-term metabolic phenotypes and disease susceptibility. This review critically examines the current evidence positioning placental EVs as key messengers in maternal\u2013fetal communication, evaluates the strength of evidence supporting their role in shaping offspring metabolic health, identifies major knowledge gaps (e.g., limited direct evidence in human offspring, lack of standardized isolation methods), and suggests their potential as early intervention biomarkers or therapeutic targets for preventing metabolic disorders in offspring. We also highlight the need for prospective cohort studies and mechanistic validation in appropriate animal models to establish causality.<\/jats:p>","DOI":"10.3390\/biom16060826","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:08:02Z","timestamp":1780535282000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Placenta-Derived Extracellular Vesicles (pdEVs): Key Mediators That Affect the Metabolic Health of Offspring in Early Nutritional Environments"],"prefix":"10.3390","volume":"16","author":[{"given":"Hanmo","family":"Lin","sequence":"first","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuhan","family":"Shao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaolin","family":"Ren","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ren","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zeng","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9846-0141","authenticated-orcid":false,"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhua","family":"Xiao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"ref_1","first-page":"545","article-title":"Fetal, Infant, and Childhood Growth Are Predictors of Coronary Heart Disease, Diabetes, and Hypertension in Adult Men and Women","volume":"108","author":"Osmond","year":"2000","journal-title":"Environ. Health Perspect."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1136\/bmj.298.6673.564","article-title":"Growth in Utero, Blood Pressure in Childhood and Adult Life, and Mortality from Cardiovascular Disease","volume":"298","author":"Barker","year":"1989","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1071\/RD13290","article-title":"Parental Diet, Pregnancy Outcomes and Offspring Health: Metabolic Determinants in Developing Oocytes and Embryos","volume":"26","author":"Sinclair","year":"2013","journal-title":"Reprod. Fertil. Dev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1038\/s41366-021-01042-7","article-title":"Effects of Paternal Overnutrition and Interventions on Future Generations","volume":"46","author":"Billah","year":"2022","journal-title":"Int. J. Obes."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Shrestha, N., Melvin, S.D., McKeating, D.R., Holland, O.J., Cuffe, J.S.M., Perkins, A.V., McAinch, A.J., and Hryciw, D.H. (2021). Sex-Specific Differences in Lysine, 3-Hydroxybutyric Acid and Acetic Acid in Offspring Exposed to Maternal and Postnatal High Linoleic Acid Diet, Independent of Diet. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms221910223"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Smith, E.V.L., Dyson, R.M., Vanderboor, C.M.G., Sarr, O., Anderson, J., Berry, M.J., Regnault, T.R.H., Peng, L., and Gray, C. (2022). Maternal Fructose Intake Causes Developmental Reprogramming of Hepatic Mitochondrial Catalytic Activity and Lipid Metabolism in Weanling and Young Adult Offspring. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23020999"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.maturitas.2011.06.017","article-title":"Hungry in the Womb: What Are the Consequences? Lessons from the Dutch Famine","volume":"70","author":"Roseboom","year":"2011","journal-title":"Maturitas"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1113\/jphysiol.2008.163477","article-title":"Maternal Nutritional History Predicts Obesity in Adult Offspring Independent of Postnatal Diet","volume":"587","author":"Howie","year":"2009","journal-title":"J. Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1093\/nutrit\/nuae048","article-title":"Nutrigenetic and Epigenetic Mechanisms of Maternal Nutrition\u2013Induced Glucolipid Metabolism Changes in the Offspring","volume":"83","author":"Jiao","year":"2025","journal-title":"Nutr. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1146\/annurev-cellbio-100814-125620","article-title":"Placenta: The Forgotten Organ","volume":"31","author":"Maltepe","year":"2015","journal-title":"Annu. Rev. Cell Dev. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1038\/s41593-021-00896-4","article-title":"Placental Endocrine Function Shapes Cerebellar Development and Social Behavior","volume":"24","author":"Vacher","year":"2021","journal-title":"Nat. Neurosci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/s41586-022-04557-9","article-title":"Compartmentalized Metabolism Supports Midgestation Mammalian Development","volume":"604","author":"Solmonson","year":"2022","journal-title":"Nature"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1146\/annurev-immunol-032712-100003","article-title":"Immunology of the Maternal-Fetal Interface","volume":"31","author":"Erlebacher","year":"2013","journal-title":"Annu. Rev. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"eaau6977","DOI":"10.1126\/science.aau6977","article-title":"The Biology, Function, and Biomedical Applications of Exosomes","volume":"367","author":"Kalluri","year":"2020","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.tcb.2015.01.004","article-title":"Ectosomes and Exosomes: Shedding the Confusion between Extracellular Vesicles","volume":"25","author":"Cocucci","year":"2015","journal-title":"Trends Cell Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ceb.2014.05.004","article-title":"Biogenesis and Secretion of Exosomes","volume":"29","author":"Kowal","year":"2014","journal-title":"Curr. Opin. Cell Biol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3703","DOI":"10.1096\/fj.13-239053","article-title":"Syncytin Proteins Incorporated in Placenta Exosomes Are Important for Cell Uptake and Show Variation in Abundance in Serum Exosomes from Patients with Preeclampsia","volume":"28","author":"Vargas","year":"2014","journal-title":"FASEB J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/s41576-019-0169-4","article-title":"Mechanisms of Early Placental Development in Mouse and Humans","volume":"21","author":"Hemberger","year":"2020","journal-title":"Nat. Rev. Genet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s00018-022-04377-0","article-title":"Early Human Trophoblast Development: From Morphology to Function","volume":"79","author":"Gauster","year":"2022","journal-title":"Cell. Mol. Life Sci. CMLS"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1093\/humupd\/dmy030","article-title":"Placental Formation in Early Pregnancy: How Is the Centre of the Placenta Made?","volume":"24","author":"Boss","year":"2018","journal-title":"Hum. Reprod. Update"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1053\/plac.1999.0513","article-title":"Placental Oxygen Consumption. Part I: In Vivo Studies\u2014A Review","volume":"21","author":"Carter","year":"2000","journal-title":"Placenta"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.placenta.2012.10.011","article-title":"Review: Transport across the Placenta of Mice and Women","volume":"34","author":"Dilworth","year":"2013","journal-title":"Placenta"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ahmadi, S.M., Perez, M.L., and Guardia, C.M. (2025). Secretion of Placental Peptide Hormones: Functions and Trafficking. Front. Endocrinol., 16.","DOI":"10.3389\/fendo.2025.1584303"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5011","DOI":"10.1210\/en.2007-0286","article-title":"Human Chorionic Gonadotropin Produced by the Invasive Trophoblast but Not the Villous Trophoblast Promotes Cell Invasion and Is Down-Regulated by Peroxisome Proliferator-Activated Receptor-Gamma","volume":"148","author":"Handschuh","year":"2007","journal-title":"Endocrinology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19219","DOI":"10.1073\/pnas.0504468103","article-title":"Adaptation of Nutrient Supply to Fetal Demand in the Mouse Involves Interaction between the Igf2 Gene and Placental Transporter Systems","volume":"102","author":"Angiolini","year":"2005","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1038\/nature00819","article-title":"Placental-Specific IGF-II Is a Major Modulator of Placental and Fetal Growth","volume":"417","author":"Hemberger","year":"2002","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jensen, V.F.H., M\u00f8lck, A.-M., Nowak, J., Wohlfarth, M., N\u00fcsken, E., Demozay, D., N\u00fcsken, K.-D., and B\u00f8gh, I.B. (2022). Placental Nutrient Transporters Adapt during Persistent Maternal Hypoglycaemia in Rats. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0265988"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Napso, T., Yong, H.E.J., Lopez-Tello, J., and Sferruzzi-Perri, A.N. (2018). The Role of Placental Hormones in Mediating Maternal Adaptations to Support Pregnancy and Lactation. Front. Physiol., 9.","DOI":"10.3389\/fphys.2018.01091"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1515\/jpm-2015-0091","article-title":"A Clinical Study Which Relates to a Theoretical Simulation of the Glucose Transport in the Human Placenta under Various Diabetic Conditions","volume":"44","author":"Barta","year":"2016","journal-title":"J. Perinat. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1016\/j.bbadis.2019.06.002","article-title":"Human Placental GLUT1 Glucose Transporter Expression and the Fetal Insulin-like Growth Factor Axis in Pregnancies Complicated by Diabetes","volume":"1865","author":"Borges","year":"2019","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1161\/CIRCRESAHA.124.325119","article-title":"Placental Hypoxia-Induced Ferroptosis Drives Vascular Damage in Preeclampsia","volume":"136","author":"Park","year":"2025","journal-title":"Circ. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1038\/nri855","article-title":"Exosomes: Composition, Biogenesis and Function","volume":"2","author":"Zitvogel","year":"2002","journal-title":"Nat. Rev. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3390\/genes4020152","article-title":"Signaling Pathways in Exosomes Biogenesis, Secretion and Fate","volume":"4","author":"Urbanelli","year":"2013","journal-title":"Genes"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Margolis, L., and Sadovsky, Y. (2019). The Biology of Extracellular Vesicles: The Known Unknowns. PLoS Biol., 17.","DOI":"10.1371\/journal.pbio.3000363"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1146\/annurev-cellbio-101512-122326","article-title":"Biogenesis, Secretion, and Intercellular Interactions of Exosomes and Other Extracellular Vesicles","volume":"30","author":"Colombo","year":"2014","journal-title":"Annu. Rev. Cell Dev. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1396823","DOI":"10.1080\/20013078.2017.1396823","article-title":"Updating the MISEV Minimal Requirements for Extracellular Vesicle Studies: Building Bridges to Reproducibility","volume":"6","author":"Witwer","year":"2017","journal-title":"J. Extracell. Vesicles"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"26913","DOI":"10.3402\/jev.v3.26913","article-title":"Minimal Experimental Requirements for Definition of Extracellular Vesicles and Their Functions: A Position Statement from the International Society for Extracellular Vesicles","volume":"3","author":"Hill","year":"2014","journal-title":"J. Extracell. Vesicles"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/j.1600-0897.2010.00822.x","article-title":"The Role of Placental Exosomes in Reproduction","volume":"63","author":"Baranov","year":"2010","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Lan, M., and Chen, Y. (2024). Minimal Information for Studies of Extracellular Vesicles (MISEV): Ten-Year Evolution (2014\u20132023). Pharmaceutics, 16.","DOI":"10.3390\/pharmaceutics16111394"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1600-0897.2006.00435.x","article-title":"Specific Isolation of Placenta-Derived Exosomes from the Circulation of Pregnant Women and Their Immunoregulatory Consequences","volume":"56","author":"Sabapatha","year":"2006","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mincheva-Nilsson, L. (2021). Immunosuppressive Protein Signatures Carried by Syncytiotrophoblast-Derived Exosomes and Their Role in Human Pregnancy. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.717884"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3585","DOI":"10.4049\/jimmunol.176.6.3585","article-title":"Placenta-Derived Soluble MHC Class I Chain-Related Molecules down-Regulate NKG2D Receptor on Peripheral Blood Mononuclear Cells during Human Pregnancy: A Possible Novel Immune Escape Mechanism for Fetal Survival","volume":"176","author":"Nagaeva","year":"2006","journal-title":"J. Immunol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"12048","DOI":"10.1073\/pnas.1304718110","article-title":"Human Placental Trophoblasts Confer Viral Resistance to Recipient Cells","volume":"110","author":"Donker","year":"2013","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_44","first-page":"e70710","article-title":"Exosome miRNA Profiles: The Reduced Expression of miRNA-27a-5p and Predictive miRNAs for Gestational Diabetes Mellitus","volume":"39","author":"Shen","year":"2025","journal-title":"FASEB J. Off. Publ. Fed. Am. Soc. Exp. Biol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Burkova, E.E., Sedykh, S.E., and Nevinsky, G.A. (2021). Human Placenta Exosomes: Biogenesis, Isolation, Composition, and Prospects for Use in Diagnostics. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22042158"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.placenta.2021.02.012","article-title":"Extracellular Vesicles and Their Role in Gestational Diabetes Mellitus","volume":"113","author":"Devaskar","year":"2021","journal-title":"Placenta"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11892-017-0834-y","article-title":"Early Pregnancy Biochemical Predictors of Gestational Diabetes Mellitus","volume":"17","author":"Powe","year":"2017","journal-title":"Curr. Diab. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e13361","DOI":"10.1111\/aji.13361","article-title":"Extracellular Vesicles and Their Potential Role Inducing Changes in Maternal Insulin Sensitivity during Gestational Diabetes Mellitus","volume":"85","author":"Nair","year":"2021","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1021\/acssensors.3c00689","article-title":"Placental Exosomes as Biomarkers for Maternal Diseases: Current Advances in Isolation, Characterization, and Detection","volume":"8","author":"Nguyen","year":"2023","journal-title":"ACS Sens."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1161\/HYPERTENSIONAHA.118.11706","article-title":"Exosomes From Women With Preeclampsia Induced Vascular Dysfunction by Delivering sFlt (Soluble Fms-Like Tyrosine Kinase)-1 and sEng (Soluble Endoglin) to Endothelial Cells","volume":"72","author":"Chang","year":"2018","journal-title":"Hypertension"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1039\/D0LC01323D","article-title":"Extracellular Vesicle Mediated Feto-Maternal HMGB1 Signaling Induces Preterm Birth","volume":"21","author":"Radnaa","year":"2021","journal-title":"Lab. Chip"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Wang, Y., Yuan, Y., Shen, S., Ge, Z., Zhu, D., and Bi, Y. (2023). Placenta-Derived Exosomes Exacerbate Beta Cell Dysfunction in Gestational Diabetes Mellitus through Delivery of miR-320b. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1282075"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"3729","DOI":"10.1111\/jcmm.17941","article-title":"Placenta-Derived Exosomal miR-135a-5p Promotes Gestational Diabetes Mellitus Pathogenesis by Activating PI3K\/AKT Signalling Pathway via SIRT1","volume":"27","author":"Zhang","year":"2023","journal-title":"J. Cell. Mol. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1186\/s12967-021-02999-9","article-title":"Extracellular Vesicle-Associated miRNAs Are an Adaptive Response to Gestational Diabetes Mellitus","volume":"19","author":"Nair","year":"2021","journal-title":"J. Transl. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"931","DOI":"10.3892\/ijmm.2016.2499","article-title":"MicroRNA-29a Induces Insulin Resistance by Targeting PPAR\u03b4 in Skeletal Muscle Cells","volume":"37","author":"Zhou","year":"2016","journal-title":"Int. J. Mol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.placenta.2025.10.002","article-title":"Exosomal miR-152-5p Promotes Trophoblast Apoptosis by Inhibiting the PI3K\/AKT\/FOXO3a Signaling Pathway via Targeting VAMP3 in Gestational Diabetes Mellitus","volume":"172","author":"Zhang","year":"2025","journal-title":"Placenta"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Zhang, W., Zhao, X., and Li, L. (2022). Downregulationof Circ_0001578 Promotes Gestational Diabetes Mellitus by Inducing Placental Inflammation via the NF-\u03baB and JNKs Pathways. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.657802"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.placenta.2023.09.008","article-title":"Exosome Enriched Leucine-Rich Alpha-2-Glycoprotein-1 and Extracellular Matrix Protein 1 Proteins Induce Abnormal Placental Angiogenesis in Pregnant Mice","volume":"143","author":"Yao","year":"2023","journal-title":"Placenta"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s00592-022-01910-2","article-title":"Human Placenta Mesenchymal Stem Cell-Derived Exosome Shuttling microRNA-130b-3p from Gestational Diabetes Mellitus Patients Targets ICAM-1 and Perturbs Human Umbilical Vein Endothelial Cell Angiogenesis","volume":"59","author":"Gao","year":"2022","journal-title":"Acta Diabetol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Zhang, L., Wu, Q., Zhu, S., Tang, Y., Chen, Y., Chen, D., and Liang, Z. (2022). Chemerin-Induced Down-Regulation of Placenta-Derived Exosomal miR-140-3p and miR-574-3p Promotes Umbilical Vein Endothelial Cells Proliferation, Migration, and Tube Formation in Gestational Diabetes Mellitus. Cells, 11.","DOI":"10.3390\/cells11213457"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1210\/clinem\/dgad751","article-title":"Early-Pregnancy Serum Maternal and Placenta-Derived Exosomes miRNAs Vary Based on Pancreatic \u03b2-Cell Function in GDM","volume":"109","author":"Quevedo","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1111\/jdi.13493","article-title":"Diagnostic Value of Dysregulated Microribonucleic Acids in the Placenta and Circulating Exosomes in Gestational Diabetes Mellitus","volume":"12","author":"Zhang","year":"2021","journal-title":"J. Diabetes Investig."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1210\/jc.2018-01599","article-title":"Adipose Tissue Exosomal Proteomic Profile Reveals a Role on Placenta Glucose Metabolism in Gestational Diabetes Mellitus","volume":"104","author":"Jayabalan","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Jayabalan, N., Nair, S., Nuzhat, Z., Rice, G.E., Zu\u00f1iga, F.A., Sobrevia, L., Leiva, A., Sanhueza, C., Guti\u00e9rrez, J.A., and Lappas, M. (2017). Cross Talk between Adipose Tissue and Placenta in Obese and Gestational Diabetes Mellitus Pregnancies via Exosomes. Front. Endocrinol., 8.","DOI":"10.3389\/fendo.2017.00239"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"546","DOI":"10.3892\/ijmm.2020.4626","article-title":"Placental Exosomes Isolated from Urine of Patients with Gestational Diabetes Exhibit a Differential Profile Expression of microRNAs across Gestation","volume":"46","author":"Noyola","year":"2020","journal-title":"Int. J. Mol. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.placenta.2023.04.006","article-title":"Placental Exosomal miR-125b Triggered Endothelial Barrier Injury in Preeclampsia","volume":"137","author":"Wu","year":"2023","journal-title":"Placenta"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.molimm.2020.10.019","article-title":"Transfer of miR-15a-5p by Placental Exosomes Promotes Pre-Eclampsia Progression by Regulating PI3K\/AKT Signaling Pathway via CDK1","volume":"128","author":"Wang","year":"2020","journal-title":"Mol. Immunol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s41065-022-00250-z","article-title":"miR-31-5p from Placental and Peripheral Blood Exosomes Is a Potential Biomarker to Diagnose Preeclampsia","volume":"159","author":"Zou","year":"2022","journal-title":"Hereditas"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.1007\/s12015-025-10935-3","article-title":"Downregulated miR-199a-3p in Preeclamptic Placenta-Derived Exosomes from Cord Blood Hinders VEGF-Induced Fetal Glomerular Dysplasia Through Inhibiting Akt1(S473) Phosphorylation via Targeting PHLPP2","volume":"21","author":"Jiang","year":"2025","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Zhang, S., Wang, L., Zhao, B., Dai, T., Nie, M., Tong, L., Zeng, Q., Guo, W., Shen, Y., and Du, D. (2026). Placental Exosomal miR-372-3p Drives Preeclampsia Progression by Inducing Mitochondrial Damage in RVLM Neurons. Cell. Mol. Biol. Lett.","DOI":"10.1186\/s11658-026-00929-5"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e38188","DOI":"10.1097\/MD.0000000000038188","article-title":"Prediction of Severe Preeclampsia and Intrauterine Growth Restriction Based on Serum Placental Exosome miR-520a-5p Levels during the First-Trimester","volume":"103","author":"Xu","year":"2024","journal-title":"Medicine"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3182","DOI":"10.1210\/jc.2017-00672","article-title":"Placental Exosomes as Early Biomarker of Preeclampsia: Potential Role of Exosomal MicroRNAs Across Gestation","volume":"102","author":"Salomon","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1210\/en.2018-00073","article-title":"Amniotic Fluid Exosome Proteomic Profile Exhibits Unique Pathways of Term and Preterm Labor","volume":"159","author":"Dixon","year":"2018","journal-title":"Endocrinology"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Hussein, S., Ju, W., Pizzella, S., Flory, M., Chu, C., Wang, Y., and Zhong, N. (2022). Reduced Expression in Preterm Birth of sFLT-1 and PlGF with a High sFLT-1\/PlGF Ratio in Extracellular Vesicles Suggests a Potential Biomarker. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.1024587"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Truong, G., Guanzon, D., Kinhal, V., Elfeky, O., Lai, A., Longo, S., Nuzhat, Z., Palma, C., Scholz-Romero, K., and Menon, R. (2017). Oxygen Tension Regulates the miRNA Profile and Bioactivity of Exosomes Released from Extravillous Trophoblast Cells\u2014Liquid Biopsies for Monitoring Complications of Pregnancy. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0174514"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"681.e1","DOI":"10.1016\/j.ajog.2021.06.075","article-title":"Placental Extracellular Vesicles-Associated microRNA-519c Mediates Endotoxin Adaptation in Pregnancy","volume":"225","author":"Tiozzo","year":"2021","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_77","first-page":"42","article-title":"Environmental Pollutant Induced Cellular Injury Is Reflected in Exosomes from Placental Explants","volume":"89","author":"Radnaa","year":"2019","journal-title":"Placenta"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/biof.1461","article-title":"microRNA-96 Protects Pancreatic \u03b2-Cell Function by Targeting PAK1 in Gestational Diabetes Mellitus","volume":"44","author":"Li","year":"2018","journal-title":"BioFactors Oxf. Engl."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1800164","DOI":"10.1002\/pmic.201800164","article-title":"Quantitative Proteomics by SWATH-MS Suggest an Association Between Circulating Exosomes and Maternal Metabolic Changes in Gestational Diabetes Mellitus","volume":"19","author":"Jayabalan","year":"2019","journal-title":"Proteomics"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"123369","DOI":"10.1016\/j.lfs.2025.123369","article-title":"Gestational Diabetes Mellitus-Derived miR-7-19488 Targets PIK3R2 mRNA to Stimulate the Abnormal Development and Maturation of Offspring-Islets","volume":"363","author":"Xu","year":"2025","journal-title":"Life Sci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.placenta.2020.11.002","article-title":"miR-15b-5p Promotes Expression of Proinflammatory Cytokines in Human Placenta by Inhibiting Apelin Signaling Pathway","volume":"104","author":"Yadava","year":"2021","journal-title":"Placenta"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1038\/s41419-018-0713-8","article-title":"Placental Exosome-Mediated Bta-miR-499-Lin28B\/Let-7 Axis Regulates Inflammatory Bias during Early Pregnancy","volume":"9","author":"Zhao","year":"2018","journal-title":"Cell Death Dis."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Chang, C.-Y., Chen, K.-Y., Shih, H.-J., Chiang, M., Huang, I.-T., Huang, Y.-H., and Huang, C.-J. (2021). Let-7i-5p Mediates the Therapeutic Effects of Exosomes from Human Placenta Choriodecidual Membrane-Derived Mesenchymal Stem Cells on Mitigating Endotoxin-Induced Mortality and Liver Injury in High-Fat Diet-Induced Obese Mice. Pharmaceuticals, 15.","DOI":"10.3390\/ph15010036"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1038\/s41390-020-1060-x","article-title":"Maternal Diabetes Alters microRNA Expression in Fetal Exosomes, Human Umbilical Vein Endothelial Cells and Placenta","volume":"89","author":"Shah","year":"2021","journal-title":"Pediatr. Res."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s12933-022-01597-3","article-title":"The Link between Gestational Diabetes and Cardiovascular Diseases: Potential Role of Extracellular Vesicles","volume":"21","author":"Ormazabal","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"9603271221149656","DOI":"10.1177\/09603271221149656","article-title":"Hyperglycemia-Induced Endothelial Exosomes Trigger Trophoblast Dysregulation and Abnormal Placentation through PUM2-Mediated Repression of SOX2","volume":"42","author":"Zhu","year":"2023","journal-title":"Hum. Exp. Toxicol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e2404983","DOI":"10.1002\/advs.202404983","article-title":"The Placenta Regulates Intrauterine Fetal Growth via Exosomal PPAR\u03b3","volume":"12","author":"Luo","year":"2025","journal-title":"Adv. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e1064","DOI":"10.1002\/iid3.1064","article-title":"LncRNA HOTAIR Regulates the PI3K\/AKT Pathway via the miR-126-3p\/PIK3R2 Axis to Participate in Synovial Angiogenesis in Rheumatoid Arthritis","volume":"11","author":"Liu","year":"2023","journal-title":"Immun. Inflamm. Dis."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"105300","DOI":"10.1016\/j.jff.2022.105300","article-title":"Probiotics Alleviate Maternal Metabolic Disorders and Offspring-Islet Abnormalities in Gestational Diabetic Mice","volume":"99","author":"Hu","year":"2022","journal-title":"J. Funct. Foods"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"122514","DOI":"10.1016\/j.lfs.2024.122514","article-title":"Human Gestational Diabetes Mellitus-Derived Exosomes Impair Glucose Homeostasis in Pregnant Mice and Stimulate Functional Maturation of Offspring-Islets","volume":"342","author":"Zou","year":"2024","journal-title":"Life Sci."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/j.cell.2012.07.029","article-title":"Pancreatic \u03b2 Cell Dedifferentiation as a Mechanism of Diabetic \u03b2 Cell Failure","volume":"150","author":"Talchai","year":"2012","journal-title":"Cell"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"13106","DOI":"10.1074\/jbc.RA119.008649","article-title":"AMPK and AKT Protein Kinases Hierarchically Phosphorylate the N-Terminus of the FOXO1 Transcription Factor, Modulating Interactions with 14-3-3 Proteins","volume":"294","author":"Saline","year":"2019","journal-title":"J. Biol. Chem."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2583047","DOI":"10.1155\/2019\/2583047","article-title":"A New Way for Beta Cell Neogenesis: Transdifferentiation from Alpha Cells Induced by Glucagon-Like Peptide 1","volume":"2019","author":"Zhang","year":"2019","journal-title":"J. Diabetes Res."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"101014","DOI":"10.1016\/j.molmet.2020.101014","article-title":"Human Islets Contain a Subpopulation of Glucagon-like Peptide-1 Secreting \u03b1 Cells That Is Increased in Type 2 Diabetes","volume":"39","author":"Campbell","year":"2020","journal-title":"Mol. Metab."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Jamilian, M., Samimi, M., Mirhosseini, N., Afshar Ebrahimi, F., Aghadavod, E., Taghizadeh, M., and Asemi, Z. (2018). A Randomized Double-Blinded, Placebo-Controlled Trial Investigating the Effect of Fish Oil Supplementation on Gene Expression Related to Insulin Action, Blood Lipids, and Inflammation in Gestational Diabetes Mellitus-Fish Oil Supplementation and Gestational Diabetes. Nutrients, 10.","DOI":"10.3390\/nu10020163"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1113\/JP280593","article-title":"Mitochondrial Dysfunction in Placental Trophoblast Cells Experiencing Gestational Diabetes Mellitus","volume":"599","author":"Fisher","year":"2020","journal-title":"J. Physiol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"E1468","DOI":"10.1210\/jc.2012-1064","article-title":"Placental Expression of Peroxisome Proliferator-Activated Receptor \u03b3 (PPAR\u03b3): Relation to Placental and Fetal Growth","volume":"97","author":"Bassols","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2386","DOI":"10.1161\/HYPERTENSIONAHA.123.21645","article-title":"Rosiglitazone-Mediated Activation of PPAR\u03b3 Restores HO1 Expression in the Human Preeclamptic Placenta","volume":"80","author":"Grimaldi","year":"2023","journal-title":"Hypertension"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1089\/scd.2012.0596","article-title":"Hypoxia and Trophoblast Differentiation: A Key Role for PPAR\u03b3","volume":"22","author":"Tache","year":"2013","journal-title":"Stem Cells Dev."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1016\/j.placenta.2009.09.006","article-title":"Expression and Regulation by PPARgamma of hCG Alpha- and Beta-Subunits: Comparison between Villous and Invasive Extravillous Trophoblastic Cells","volume":"30","author":"Handschuh","year":"2009","journal-title":"Placenta"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1038\/nrm3198","article-title":"Forming Functional Fat: A Growing Understanding of Adipocyte Differentiation","volume":"12","author":"Cristancho","year":"2011","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1681\/ASN.2018060599","article-title":"LRG1 Promotes Diabetic Kidney Disease Progression by Enhancing TGF-\u03b2-Induced Angiogenesis","volume":"30","author":"Hong","year":"2019","journal-title":"J. Am. Soc. Nephrol. JASN"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.1016\/j.ymthe.2024.06.027","article-title":"LRG1 Loss Effectively Restrains Glomerular TGF-\u03b2 Signaling to Attenuate Diabetic Kidney Disease","volume":"32","author":"Wang","year":"2024","journal-title":"Mol. Ther. J. Am. Soc. Gene Ther."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1096\/fsb2fj990934com","article-title":"Extracellular Matrix Protein 1 (ECM1) Has Angiogenic Properties and Is Expressed by Breast Tumor Cells","volume":"15","author":"Han","year":"2001","journal-title":"FASEB J."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Park, H.N., Song, M.J., Choi, Y.E., Lee, D.H., Chung, J.H., and Lee, S.-T. (2023). LRG1 Promotes ECM Integrity by Activating the TGF-\u03b2 Signaling Pathway in Fibroblasts. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241512445"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12964-021-00782-3","article-title":"Extracellular Vesicles from Maternal Uterine Cells Exposed to Risk Factors Cause Fetal Inflammatory Response","volume":"19","author":"Shepherd","year":"2021","journal-title":"Cell Commun. Signal."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1093\/biolre\/ioz233","article-title":"Uterine Epithelial Expression of the Tumor Necrosis Factor Superfamily: A Strategy for Immune Privilege during Pregnancy in a True Epitheliochorial Placentation Species","volume":"102","author":"Yoo","year":"2020","journal-title":"Biol. Reprod."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1007\/s43032-020-00237-z","article-title":"Adiponectin Reduces Embryonic Loss Rate and Ameliorates Trophoblast Apoptosis in Early Pregnancy of Mice with Polycystic Ovary Syndrome by Affecting the AMPK\/PI3K\/Akt\/FoxO3a Signaling Pathway","volume":"27","author":"Zhang","year":"2020","journal-title":"Reprod. Sci."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"4363","DOI":"10.1111\/jcmm.16499","article-title":"Potential Role of FoxO3a in the Regulation of Trophoblast Development and Pregnancy Complications","volume":"25","author":"Chen","year":"2021","journal-title":"J. Cell. Mol. Med."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.cyto.2011.12.004","article-title":"Cytokine Profile, Metabolic Syndrome and Cardiovascular Disease Risk in Women with Late-Onset Gestational Diabetes Mellitus","volume":"58","author":"Roca","year":"2012","journal-title":"Cytokine"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"3169","DOI":"10.1080\/14767058.2019.1678141","article-title":"IL-1\u03b2 and IL-10 Gene Polymorphisms in Women with Gestational Diabetes","volume":"34","author":"Majcher","year":"2021","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1600-0897.2010.00880.x","article-title":"Trophoblast-Derived Exosomes Mediate Monocyte Recruitment and Differentiation","volume":"65","author":"Atay","year":"2011","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Bai, K., Li, X., Zhong, J., Ng, E.H.Y., Yeung, W.S.B., Lee, C.-L., and Chiu, P.C.N. (2021). Placenta-Derived Exosomes as a Modulator in Maternal Immune Tolerance During Pregnancy. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.671093"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Chiang, M.D., Chang, C.-Y., Shih, H.-J., Le, V.L., Huang, Y.-H., and Huang, C.-J. (2022). Exosomes from Human Placenta Choriodecidual Membrane-Derived Mesenchymal Stem Cells Mitigate Endoplasmic Reticulum Stress, Inflammation, and Lung Injury in Lipopolysaccharide-Treated Obese Mice. Antioxidants, 11.","DOI":"10.3390\/antiox11040615"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"110691","DOI":"10.1016\/j.diabres.2023.110691","article-title":"Association between Obesity, Inflammation and Insulin Resistance: Insights into Signaling Pathways and Therapeutic Interventions","volume":"200","author":"Kushwaha","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Mirra, P., Nigro, C., Prevenzano, I., Leone, A., Raciti, G.A., Formisano, P., Beguinot, F., and Miele, C. (2018). The Destiny of Glucose from a MicroRNA Perspective. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00046"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/6\/826\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:38:15Z","timestamp":1780720695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/6\/826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":116,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["biom16060826"],"URL":"https:\/\/doi.org\/10.3390\/biom16060826","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]}}}