Most detailed map of uterus lining sheds light on endometriosis
The most detailed map of the endometrium, the inner lining of the uterus, has been made - and it could bring better understanding of multiple health conditions, including endometriosis, infertility and abnormal menstruation.
Roser Vento-Tormo and her colleagues at the Wellcome Sanger Institute in the UK examined more than 313,000 endometrial cells from 63 individuals of reproductive age to illustrate the organ, releasing their findings in Nature Genetics.
The endometrium changes dynamically throughout the month, thickening in preparation for pregnancy and shedding its top layer during menstruation if pregnancy does not occur.
The team used information from six previously released datasets alongside material from 16 new donors, taking samples throughout the menstrual cycle. Of the participants examined, 30 had been diagnosed with endometriosis and 14 were using hormonal medication either for treating endometriosis or for birth control. Endometriosis is a painful, chronic condition where tissue like the uterus lining grows outside the uterus, affecting about 10% of menstruating individuals.
Due to a technique called single-cell sequencing, the researchers were able to tell which genes were turned on or off in every cell. They were therefore able to identify each type of cell and learn more about how they worked. Endometrium tissue samples were also studied under a microscope to ascertain cell structure and location. The entire spread of cells in the endometrium was laid out this way, including how some changed during the menstrual cycle.
What does the map tell us about endometriosis?
The map sheds leads to a greater understanding of endometriosis, as the team were able to identify differences in communication between cells and in cell function through studying samples from donors with and without the condition. Endometrial cells showed damaged communication between the endometrium's structural cells and cells that respond to hormonal changes, which may be a factor in endometrial inflammation.
Vento-Tormo and her team also found previously unknown cell types, including one in the endometrium's lower layer that changes through different stages of the menstrual cycle. it plays an important part in rebuilding the uterine lining's upper layer after it is shed during menstruation and can form into other types of endometrial cells. Damages to these cells may lead to heavy bleeding or other conditions where endometriosis doesn't fully develop, suggests Christine Metz at Feinstein Institutes for Medical Research in New York, who wasn’t involved in the study.
Vento-Tormo said that the image may also improve our understanding of the causes behind infertility and why some embryos cannot implant in the uterine lining.
The organ was more adaptable than previously thought, its composition changing every four days or so. 'It was a bit unexpected, even for us, how dynamic it was', says Vento-Tormo.
More samples from other donors may needed to illustrate the organ's full intricacy, and how it alters during menstruation, says Metz. However, the map is still a fundamental new development that will contribute to future research. 'This map is going to contribute immensely in the coming years to understanding conditions that affect the endometrium,' Metz says.
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