Exosomes isolated from pregnant women promoted the release of proinflammatory cytokines (IL-4, IL-6, IL-8, IFN-γ, TNF-α) from human umbilical vein endothelial cells (HUVECs) and this effect was significantly greater when exosomes isolated from gestational diabetes mellitus (GDM) pregnancies were used [59]. Here, IL4 is linked to gestational diabetes.