In addition, others studies also demonstrated that HG can trigger the release of EVs by trophoblast cells and placental EVs has biological activity, which in turn increase the release of proinflammatory cytokines such as GM-CSF, IL-6, IL-8, IL-10, and TNF-α from endothelial cells [5, 18] and promote the proinflammatory state of pregnant women with GDM. The gene discussed is TNF; the disease is gestational diabetes.