Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions

Abstract Background Intrauterine adhesions (IUAs) is a gynecological condition with a poor therapeutic prognosis, that severely threatens the fertility and the reproductive physiology and psychological health of women. Our previous research on the use of umbilical cord mesenchymal stem cells (HUCMSC...

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Main Authors: Xiaotong Xu, Kaixuan Guo, Peng Zhao, Xuemei Zhang, Pan Zhao, Xianghang Sun, Mingle Zhang, Yanpeng Tian, Li Fen, Jiahua Zheng, Xianghua Huang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03661-y
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author Xiaotong Xu
Kaixuan Guo
Peng Zhao
Xuemei Zhang
Pan Zhao
Xianghang Sun
Mingle Zhang
Yanpeng Tian
Li Fen
Jiahua Zheng
Xianghua Huang
author_facet Xiaotong Xu
Kaixuan Guo
Peng Zhao
Xuemei Zhang
Pan Zhao
Xianghang Sun
Mingle Zhang
Yanpeng Tian
Li Fen
Jiahua Zheng
Xianghua Huang
author_sort Xiaotong Xu
collection DOAJ
description Abstract Background Intrauterine adhesions (IUAs) is a gynecological condition with a poor therapeutic prognosis, that severely threatens the fertility and the reproductive physiology and psychological health of women. Our previous research on the use of umbilical cord mesenchymal stem cells (HUCMSCs) for treating IUAs revealed that CM-Dil-labelled HUCMSCs were barely distributed in the endometrial epithelium. Instead, these cells were predominantly found in the myometrium, with no statistically significant difference in distribution compared to the endometrial stromal cells. Therefore, we aimed to explore the associations between the myometrium and IUAs. Methods Eight patients with moderate and 5 severe lesional IUAs were included in the experimental group. The control group included 7 patients whose inner and outer myometrium were normal. We used H&E, Masson's trichrome and immunohistochemical staining to obtain the pathological features of the tissues. Transcriptomic and proteomic analyses were conducted to identify differentially expressed genes, proteins and enrichment pathways. Results Both IUAs lesion tissues expressed the smooth muscle markers α-SMA and H-caldesmon, and there was no significant difference between severe IUAs tissue and normal myometrium (p > 0.05). Transcriptomic and proteomic data revealed that genes and proteins involved in cell mitosis, such as KIF14, KIF4A, and CIT, were downregulated in both IUAs lesion tissues compared with the inner myometrium (p < 0.05). Additionally, some genes or proteins that participate in activating the complement-coagulation cascade system and extracellular matrix (ECM) degradation also significantly differed (p < 0.05). Conclusions Transcriptomic and proteomic data revealed a correlation between endometrial injury and the myometrium. These findings preliminarily revealed that the myometrium possibly contributes to the aetiology and progression of IUAs through dual mechanisms. On the one hand, the myometrium inhibits endometrial regeneration by suppressing the cell mitogenic pathway. On the other hand, it promotes fibrosis by activating the complement-coagulation cascade system and inhibiting the ECM degradation pathway. These new findings increase our understanding of the pathogenesis of IUAs and potentially contribute to the application of precision clinical treatment for IUAs.
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spelling doaj-art-0e4ce9b320174f598f79afaee32a1c4b2025-08-20T02:11:42ZengBMCBMC Women's Health1472-68742025-04-0125111710.1186/s12905-025-03661-yTranscriptomics and proteomics reveal associations between myometrium and intrauterine adhesionsXiaotong Xu0Kaixuan Guo1Peng Zhao2Xuemei Zhang3Pan Zhao4Xianghang Sun5Mingle Zhang6Yanpeng Tian7Li Fen8Jiahua Zheng9Xianghua Huang10Department of Gynecology, The Second Hospital of Hebei Medical UniversityDepartment of Gynecology, The Second Hospital of Hebei Medical UniversityDepartment of Nephrology, The Second Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Pelvic Floor Clinic, Cangzhou Central HospitalDepartment of Reproductive Medicine, The Second Hospital of Hebei Medical UniversityDepartment of Gynecology, The Second Hospital of Hebei Medical UniversityDepartment of Gynecology, The Second Hospital of Hebei Medical UniversityDepartment of Gynecology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gynecology, The Fourth Hospital of ShijiazhuangDepartment of Gynecology, The Second Hospital of Hebei Medical UniversityDepartment of Gynecology, The Second Hospital of Hebei Medical UniversityAbstract Background Intrauterine adhesions (IUAs) is a gynecological condition with a poor therapeutic prognosis, that severely threatens the fertility and the reproductive physiology and psychological health of women. Our previous research on the use of umbilical cord mesenchymal stem cells (HUCMSCs) for treating IUAs revealed that CM-Dil-labelled HUCMSCs were barely distributed in the endometrial epithelium. Instead, these cells were predominantly found in the myometrium, with no statistically significant difference in distribution compared to the endometrial stromal cells. Therefore, we aimed to explore the associations between the myometrium and IUAs. Methods Eight patients with moderate and 5 severe lesional IUAs were included in the experimental group. The control group included 7 patients whose inner and outer myometrium were normal. We used H&E, Masson's trichrome and immunohistochemical staining to obtain the pathological features of the tissues. Transcriptomic and proteomic analyses were conducted to identify differentially expressed genes, proteins and enrichment pathways. Results Both IUAs lesion tissues expressed the smooth muscle markers α-SMA and H-caldesmon, and there was no significant difference between severe IUAs tissue and normal myometrium (p > 0.05). Transcriptomic and proteomic data revealed that genes and proteins involved in cell mitosis, such as KIF14, KIF4A, and CIT, were downregulated in both IUAs lesion tissues compared with the inner myometrium (p < 0.05). Additionally, some genes or proteins that participate in activating the complement-coagulation cascade system and extracellular matrix (ECM) degradation also significantly differed (p < 0.05). Conclusions Transcriptomic and proteomic data revealed a correlation between endometrial injury and the myometrium. These findings preliminarily revealed that the myometrium possibly contributes to the aetiology and progression of IUAs through dual mechanisms. On the one hand, the myometrium inhibits endometrial regeneration by suppressing the cell mitogenic pathway. On the other hand, it promotes fibrosis by activating the complement-coagulation cascade system and inhibiting the ECM degradation pathway. These new findings increase our understanding of the pathogenesis of IUAs and potentially contribute to the application of precision clinical treatment for IUAs.https://doi.org/10.1186/s12905-025-03661-yIntrauterine adhesionsIntrauterine myometriumTranscriptomicsProteomics
spellingShingle Xiaotong Xu
Kaixuan Guo
Peng Zhao
Xuemei Zhang
Pan Zhao
Xianghang Sun
Mingle Zhang
Yanpeng Tian
Li Fen
Jiahua Zheng
Xianghua Huang
Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
BMC Women's Health
Intrauterine adhesions
Intrauterine myometrium
Transcriptomics
Proteomics
title Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
title_full Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
title_fullStr Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
title_full_unstemmed Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
title_short Transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
title_sort transcriptomics and proteomics reveal associations between myometrium and intrauterine adhesions
topic Intrauterine adhesions
Intrauterine myometrium
Transcriptomics
Proteomics
url https://doi.org/10.1186/s12905-025-03661-y
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