Bao Shihua, Chen Zechuan, Qin Dengke, Xu Huihui, Deng Xujing, Zhang Ruixiu, Ma Jiaqiang, Lu Zhouping, Jiang Shan, Zhang Xiaoming
Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Hum Reprod. 2023 Jan 5;38(1):57-74. doi: 10.1093/humrep/deac240.
STUDY QUESTION: Do distinct subpopulations of decidual stromal cells (DSCs) exist and if so, are given subpopulations enriched in recurrent miscarriage (RM)? SUMMARY ANSWER: Three subpopulations of DSCs were identified from which inflammatory DSCs (iDSCs) and glycolytic DSCs (glyDSCs) are significantly enriched in RM, with implicated roles in driving decidual inflammation and immune dysregulation. WHAT IS KNOWN ALREADY: DSCs play crucial roles in establishing and maintaining a successful pregnancy; dysfunction of DSCs has been considered as one of the key reasons for the development of RM. STUDY DESIGN, SIZE, DURATION: We collected 15 early decidual samples from five healthy donors (HDs) and ten RM patients to perform single-cell RNA sequencing (scRNA-seq). A total of 43 RM patients and 37 HDs were enrolled in the validation cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS: Non-immune cells and immune cells of decidual tissues were sorted by flow cytometry to perform scRNA-seq. We used tissue microarrays (TMA) to validate three distinct subpopulations of DSCs. The expression of inflammatory and glycolytic proteins by DSCs was validated by immunohistochemistry (IHC) and multiplex immunohistochemistry (mIHC). Different subsets of decidual NK (dNK) cells and macrophages were also validated by multicolor flow cytometry and mIHC. Cell ligand-receptor and spatial analyses between DSCs and immune cells were analyzed by mIHC. MAIN RESULTS AND THE ROLE OF CHANCE: We classify the DSCs into three subtypes based on scRNA-seq data: myofibroblastic (myDSCs), inflammatory (iDSCs) and glycolytic (glyDSCs), with the latter two being significantly enriched in RM patients. The distribution patterns of DSC subtypes in the RM and HD groups were validated by mIHC. Single-cell analyses indicate that the differentiation of iDSCs and glyDSCs may be coupled with the degrees of hypoxia. Consequently, we propose a pathological model in which a vicious circle is formed and fueled by hypoxic stress, uncontrolled inflammation and aberrant glycolysis. Furthermore, our results show that the inflammatory SPP1+ macrophages and CD18+ dNK cells are preferentially increased in the decidua of RM patients. Cell ligand-receptor and mIHC spatial analyses uncovered close interactions between pathogenic DSCs and inflammatory SPP1+ macrophages and CD18+ NK cells in RM patients. LARGE SCALE DATA: The raw single-cell sequence data reported in this paper were deposited at the National Omics Data Encyclopedia (www.biosino.org), under the accession number OEP002901. LIMITATIONS, REASONS FOR CAUTION: The number of decidual samples for scRNA-seq was limited and in-depth functional studies on DSCs are warranted in future studies. WIDER IMPLICATIONS OF THE FINDINGS: Identification of three DSC subpopulations opens new avenues for further investigation of their roles in RM patients. STUDY FUNDING/COMPETING INTEREST(S): This study was supported by the Strategic Priority Research Program (No. XDB29030302), Frontier Science Key Research Project (QYZDB-SSW-SMC036), Chinese Academy of Sciences; National Key Research and Development Program of China (2021YFE0200600), National Natural Science Foundation of China (No. 31770960), Shanghai Municipal Science and Technology Major Project (No. 2019SHZDZX02, HS2021SHZX001), and Shanghai Committee of Science and Technology (17411967800). All authors report no conflict of interest.
研究问题:蜕膜基质细胞(DSCs)是否存在不同的亚群?如果存在,特定亚群在复发性流产(RM)中是否富集? 总结答案:鉴定出了DSCs的三个亚群,其中炎症性DSCs(iDSCs)和糖酵解性DSCs(glyDSCs)在RM中显著富集,在引发蜕膜炎症和免疫失调中起作用。 已知信息:DSCs在建立和维持成功妊娠中起关键作用;DSCs功能障碍被认为是RM发生的关键原因之一。 研究设计、规模、持续时间:我们从5名健康供体(HDs)和10名RM患者中收集了15份早期蜕膜样本,进行单细胞RNA测序(scRNA-seq)。共有43名RM患者和37名HDs纳入验证队列。 参与者/材料、环境、方法:通过流式细胞术对蜕膜组织中的非免疫细胞和免疫细胞进行分选,以进行scRNA-seq。我们使用组织微阵列(TMA)验证DSCs的三个不同亚群。通过免疫组织化学(IHC)和多重免疫组织化学(mIHC)验证DSCs中炎症和糖酵解蛋白的表达。蜕膜自然杀伤(dNK)细胞和巨噬细胞的不同亚群也通过多色流式细胞术和mIHC进行验证。通过mIHC分析DSCs与免疫细胞之间的细胞配体-受体和空间分析。 主要结果及偶然性作用:根据scRNA-seq数据,我们将DSCs分为三种亚型:肌成纤维细胞型(myDSCs)、炎症型(iDSCs)和糖酵解型(glyDSCs),后两者在RM患者中显著富集。通过mIHC验证了RM组和HD组中DSC亚型的分布模式。单细胞分析表明,iDSCs和glyDSCs的分化可能与缺氧程度相关。因此,我们提出了一个病理模型,其中缺氧应激、不受控制的炎症和异常糖酵解形成并加剧恶性循环。此外,我们的结果表明,炎症性SPP1+巨噬细胞和CD18+ dNK细胞在RM患者的蜕膜中优先增加。细胞配体-受体和mIHC空间分析揭示了RM患者中致病性DSCs与炎症性SPP1+巨噬细胞和CD18+ NK细胞之间的密切相互作用。 大规模数据:本文报道的原始单细胞序列数据已存入国家组学数据百科全书(www.biosino.org),登录号为OEP002901。 局限性、注意事项:用于scRNA-seq的蜕膜样本数量有限,未来研究有必要对DSCs进行深入的功能研究。 研究结果的更广泛影响:鉴定出三个DSC亚群为进一步研究它们在RM患者中的作用开辟了新途径。 研究资金/利益冲突:本研究得到中国科学院战略性先导科技专项(编号:XDB29030302)、前沿科学重点研究项目(QYZDB-SSW-SMC036);国家重点研发计划(2021YFE0200600)、国家自然科学基金(编号:31770960)、上海市科技重大专项(编号:2019SHZDZX02,HS2021SHZX001)以及上海市科学技术委员会(17411967800)的支持。所有作者均声明无利益冲突。
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