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The role of decidual subpopulations at implantation, menstruation and miscarriage
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Muter, Joanne, Seng-Kong, Chow and Brosens, Jan J. (2021) The role of decidual subpopulations at implantation, menstruation and miscarriage. Frontiers in Reproductive Health, 3 . 804921. doi:10.3389/frph.2021.804921 ISSN 2673-3153.
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WRAP-role-decidual-subpopulations-implantation-menstruation-miscarriage-Brosens-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1743Kb) | Preview |
Official URL: https://doi.org/10.3389/frph.2021.804921
Abstract
In each menstrual cycle, the endometrium becomes receptive to embryo implantation while preparing for tissue breakdown and repair. Both pregnancy and menstruation are dependent on spontaneous decidualization of endometrial stromal cells, a progesterone-dependent process that follows rapid, estrogen-dependent proliferation. During the implantation window, stromal cells mount an acute stress response, which leads to the emergence of functionally distinct decidual subsets, reflecting the level of replication stress incurred during the preceding proliferative phase. Progesterone-dependent, anti-inflammatory decidual cells (DeC) form a robust matrix and recruit bone marrow-derived decidual progenitors to accommodate the conceptus whereas pro-inflammatory, progesterone-resistant stressed and senescent decidual cells (senDeC) control tissue remodelling and breakdown. To execute these functions, each decidual subset engage innate immune cells: DeC partner with uterine natural killer (uNK) cells to eliminate senDeC, while senDeC co-opt neutrophils and macrophages to assist with tissue breakdown and repair. Thus, successful transformation of cycling endometrium into the decidua of pregnancy not only requires continues progesterone signalling but dominance of DeC over senDeC, aided by recruitment and differentiation of circulating NK cells and bone marrow-derived progenitors. We discuss how the frequency of cycles resulting in imbalanced decidual subpopulations determines the recurrence risk of miscarriage and discuss emerging therapeutic strategies.
| Item Type: | Journal Article | ||||||
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Frontiers in Reproductive Health | ||||||
| Publisher: | Frontiers Media | ||||||
| ISSN: | 2673-3153 | ||||||
| Official Date: | 23 December 2021 | ||||||
| Dates: |
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| Volume: | 3 | ||||||
| Article Number: | 804921 | ||||||
| DOI: | 10.3389/frph.2021.804921 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 15 December 2021 | ||||||
| Date of first compliant Open Access: | 4 January 2022 | ||||||
| Related URLs: |
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