Recurrent pregnancy loss is associated with a pro-senescent decidual response during the peri-implantation window

Commun Biol. 2020 Jan 21;3(1):37. doi: 10.1038/s42003-020-0763-1.

Abstract

During the implantation window, the endometrium becomes poised to transition to a pregnant state, a process driven by differentiation of stromal cells into decidual cells (DC). Perturbations in this process, termed decidualization, leads to breakdown of the feto-maternal interface and miscarriage, but the underlying mechanisms are poorly understood. Here, we reconstructed the decidual pathway at single-cell level in vitro and demonstrate that stromal cells first mount an acute stress response before emerging as DC or senescent DC (snDC). In the absence of immune cell-mediated clearance of snDC, secondary senescence transforms DC into progesterone-resistant cells that abundantly express extracellular matrix remodelling factors. Additional single-cell analysis of midluteal endometrium identified DIO2 and SCARA5 as marker genes of a diverging decidual response in vivo. Finally, we report a conspicuous link between a pro-senescent decidual response in peri-implantation endometrium and recurrent pregnancy loss, suggesting that pre-pregnancy screening and intervention may reduce the burden of miscarriage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Habitual / etiology*
  • Abortion, Habitual / metabolism
  • Cell Line
  • Cellular Senescence* / genetics
  • Decidua / metabolism*
  • Disease Susceptibility
  • Embryo Implantation* / genetics
  • Female
  • Gene Expression Profiling
  • Gene Expression Regulation, Developmental
  • Gene Regulatory Networks
  • Humans
  • Immunologic Surveillance
  • Models, Biological
  • Pregnancy
  • Signal Transduction
  • Single-Cell Analysis
  • Transcriptome