Publication Date
2-24-2024
Journal
Communications Biology
DOI
10.1038/s42003-024-05898-z
PMID
38402336
PMCID
PMC10894266
PubMedCentral® Posted Date
2-24-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Pregnancy, Female, Humans, Endometriosis, Decidua, Bone Morphogenetic Proteins, Transforming Growth Factor beta, Signal Transduction, Infertility, Pregnancy Complications, Transcriptomics, Mechanisms of disease
Abstract
Endometriosis is linked to increased infertility and pregnancy complications due to defective endometrial decidualization. We hypothesized that identification of altered signaling pathways during decidualization could identify the underlying cause of infertility and pregnancy complications. Our study reveals that transforming growth factor β (TGFβ) pathways are impaired in the endometrium of individuals with endometriosis, leading to defective decidualization. Through detailed transcriptomic analyses, we discovered abnormalities in TGFβ signaling pathways and key regulators, such as SMAD4, in the endometrium of affected individuals. We also observed compromised activity of bone morphogenetic proteins (BMP), a subset of the TGFβ family, that control endometrial receptivity. Using 3-dimensional models of endometrial stromal and epithelial assembloids, we showed that exogenous BMP2 improved decidual marker expression in individuals with endometriosis. Our findings reveal dysfunction of BMP/SMAD signaling in the endometrium of individuals with endometriosis, explaining decidualization defects and subsequent pregnancy complications in these individuals.