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Qi R, Guan R, Cai S, Xu M, Yang WJ, Wang CC. Comprehensive molecular expression profiling of SARS-CoV-associated factors in the endometrium across the menstrual cycle and elevated susceptibility in women with recurrent pregnancy loss. Front Genet 2023; 14:1246725. [PMID: 37854057 PMCID: PMC10579889 DOI: 10.3389/fgene.2023.1246725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/04/2023] [Indexed: 10/20/2023] Open
Abstract
Objective: To evaluate the dynamic expression profiling alterations of SARS-CoV-2-associated molecules within the fertile human endometrium throughout the menstrual cycle. Furthermore, to explore the inherent vulnerability of the endometrium to SARS-CoV-2 infection among women experiencing recurrent pregnancy failure, including both recurrent implantation failures (RIF) and recurrent pregnancy losses (RPL). Method: The present study employed multiple datasets to investigate the expression patterns of SARS-CoV-2-associated genes. Firstly, a single-cell RNA-sequencing dataset comprising endometrial samples from 19 healthy women across the menstrual cycle was utilized. Additionally, two microarray datasets encompassing 24 women with RIF, and 24 women with RPL during the peri-implantation phase were included. To complement these analyses, immunohistochemical (IHC) staining was performed on endometrial samples collected from 30 women with RIF, 30 women with RPL, and 20 fertile controls recruited specifically during the implantation period. Results: The investigation revealed a moderate expression percentage of CTSL (22%), TMPRSS4 (15%), FURIN (16%) and MX1 (9%) in endometrium. Conversely, the expression percentages of ACE2 (1%) and TMPRSS2 (4%) were relatively low. Notably, the expression of BSG exhibited an increment towards the window of implantation, reaching its peak during the middle secretary phase. Furthermore, a significant reduction (p < 0.05) in TMPRSS2 expression was observed in the RIF group compared to the control group. While the expression of BSG was significantly increased (p < 0.05) in the RPL group, findings that were corroborated by the IHC staining results. Conclusion: The findings of this study indicate a noteworthy upregulation of BSG expression in the endometrium of women with RPL. These results suggest an augmented susceptibility of endometrium to SARS-CoV-2 infection, potentially contributing to unfavorable pregnancy outcomes.
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Affiliation(s)
- Ruofan Qi
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, China
- Department of Obstetrics and Gynecology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Rui Guan
- Department of Obstetrics and Gynecology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Shengyun Cai
- Department of Obstetrics and Gynecology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Mingjuan Xu
- Department of Obstetrics and Gynecology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wen-jui Yang
- Department of Infertility and Reproductive Medicine, Taiwan IVF Group Center, Hsinchu, Taiwan
- Department of Fertility and Reproductive Medicine, Ton-Yen General Hospital, Hsinchu, Taiwan
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Shatin, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Chinese University of Hong Kong-Sichuan University Joint Laboratory in Reproductive Medicine, The Chinese University of Hong Kong, Hong Kong, China
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de Miguel-Gómez L, Sebastián-León P, Romeu M, Pellicer N, Faus A, Pellicer A, Díaz-Gimeno P, Cervelló I. Endometrial gene expression differences in women with coronavirus disease 2019. Fertil Steril 2022; 118:1159-1169. [PMID: 36333264 PMCID: PMC9624514 DOI: 10.1016/j.fertnstert.2022.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study the potential effect of coronavirus disease (COVID-19) on the endometrial transcriptome of affected, symptomatic women for the detection of altered gene expression. DESIGN Pilot study of the endometrial transcriptomes of women manifesting COVID-19 compared with those of women without COVID-19 undergoing hysteroscopic procedures for benign gynecologic disorders using RNA sequencing. SETTING Hospital and university laboratories. PATIENT(S) Women with (n = 14) and without a COVID-19 (n = 10) diagnosis based on a nasopharyngeal swab analysis using quantitative reverse-transcription polymerase chain reaction. The endometrium of the patients with COVID-19 had previously been tested for severe acute respiratory syndrome coronavirus 2 infection, revealing the absence of the virus in this tissue. INTERVENTION(S) Endometrial biopsy sample collection. MAIN OUTCOMES MEASURE(S) Endometrial gene expression and functional analysis of symptomatic patients with COVID-19 vs. individuals without the infection. RESULT(S) The systemic disease COVID-19 altered endometrial gene expression in 75% of the women, with the patients exhibiting a preponderance of 163 up-regulated (e.g., UTS2, IFI6, IFIH1, and BNIP3) and 72 down-regulated genes (e.g., CPZ, CDH3, and IRF4) (false discovery rate<0.05). A total of 161 dysregulated functions (36 up-regulated and 125 down-regulated) were typically enriched in the endometria of the patients with COVID-19, including up-regulation in pathways involved in the development of immune responses to viruses and cytokine inflammation, reflecting elicitation of a COVID-19 response pathway. CONCLUSION(S) Coronavirus disease 2019 affects endometrial gene expression despite the absence of severe acute respiratory syndrome coronavirus 2 RNA in endometrial tissues.
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Affiliation(s)
- Lucía de Miguel-Gómez
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, bReproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Patricia Sebastián-León
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, bReproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Mónica Romeu
- La Fe University Hospital, Valencia, Spain,Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain
| | - Nuria Pellicer
- La Fe University Hospital, Valencia, Spain,Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain
| | - Amparo Faus
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, bReproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Antonio Pellicer
- Women's Health Area, Human Reproduction Unit, La Fe University Hospital, Valencia, Spain,Pediatrics, Obstetrics, and Gynecology Department, University of Valencia, Spain
| | - Patricia Díaz-Gimeno
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, bReproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Irene Cervelló
- IVI Foundation, La Fe Health Research Institute, Valencia, Spain, bReproductive Medicine Research Group, La Fe Health Research Institute, Valencia, Spain,Correspondence: Irene Cervelló, Ph.D., IVI Foundation, La Fe Health Research Institute, 106 Fernando Abril Martorell Avenue. La Fe University Hospital, Biopolo, 1st floor, Valencia 46026
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Henarejos-Castillo I, Devesa-Peiro A, de Miguel-Gomez L, Sebastian-Leon P, Romeu M, Aleman A, Molina-Gil C, Pellicer A, Cervello I, Diaz-Gimeno P. Predicted COVID-19 molecular effects on endometrium reveal key dysregulated genes and functions. Mol Hum Reprod 2022; 28:6751797. [PMID: 36205711 DOI: 10.1093/molehr/gaac035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/12/2022] [Indexed: 11/14/2022] Open
Abstract
COVID-19 exerts systemic effects that can compromise various organs and systems. Although retrospective and in-silico studies and prospective preliminary analysis have assessed the possibility of direct infection of the endometrium, there is a lack of in-depth and prospective studies on the impact of systemic disease on key endometrial genes and functions across the menstrual cycle and window of implantation. Gene expression data has been obtained from (i) healthy secretory endometrium collected from 42 women without endometrial pathologies and (ii) nasopharyngeal swabs from 231 women with COVID-19 and 30 negative controls. To predict how COVID-19-related gene expression changes impact key endometrial genes and functions, an in-silico model was developed by integrating the endometrial and COVID-19 datasets in an affected mid-secretory endometrium gene co-expression network. An endometrial validation set comprising 16 women (8 confirmed to have COVID-19 and 8 negative test controls) was prospectively collected to validate the expression of key genes. We predicted that five genes important for embryo implantation were affected by COVID-19 (downregulation of COBL, GPX3 and SOCS3, and upregulation of DOCK2 and SLC2A3). We experimentally validated these genes in COVID19 patients using endometrial biopsies during the secretory phase of the menstrual cycle. The results generally support the in-silico model predictions, suggesting that the transcriptomic landscape changes mediated by COVID-19 affect endometrial receptivity genes and key processes necessary for fertility, such as immune system function, protection against oxidative damage and development vital for embryo implantation and early development.
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Affiliation(s)
- I Henarejos-Castillo
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - A Devesa-Peiro
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - L de Miguel-Gomez
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - P Sebastian-Leon
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - M Romeu
- Reproductive Medicine Unit, Hospital La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - A Aleman
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - C Molina-Gil
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - A Pellicer
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - I Cervello
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - P Diaz-Gimeno
- IVI Foundation, Health Research Institute La Fe (IIS La Fe), Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
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