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The fieldEndometriosis

Single-cell analysis of menstrual endometrial tissues defines phenotypes associated with endometriosis

Shih AJ, Adelson RP, Vashistha H, et al.BMC Medicine · 2022DOI 10.1186/s12916-022-02500-3

In plain language

Single-cell RNA sequencing of fresh menstrual effluent, collected at home with a menstrual cup, from 33 women: 11 with surgically confirmed endometriosis, 13 with symptoms but no diagnosis, and 9 controls. Uterine natural killer cells made up about 8% of cells in women with endometriosis against about 28% in controls, a decidualized stromal cell subset was less abundant in endometriosis, and the symptomatic group showed similar immune shifts.

Key numbers

33
Women: 11 with endometriosis, 13 with symptoms, 9 controls
8% vs 28%
Approximate share of uterine NK cells, endometriosis versus controls
43,054
Cells analyzed after quality control

What it means

Shed endometrial tissue in menstrual effluent carries cell-level differences linked to endometriosis, including fewer uterine NK cells and fewer decidualized stromal cells. The authors note that single-cell sequencing is too costly to become a test itself, but it points to markers a simpler test could use.

What it does not show

A small study of fresh, live samples from a menstrual cup, shipped cold overnight, not dried samples. The symptomatic group had no surgical diagnosis, so the study could not measure how well these profiles predict endometriosis.

Figures

Figure 3 from Single-cell menstrual tissue in endometriosis: Maps of individual cells recovered from menstrual effluent, with controls on the left and people diagnosed with endometriosis on the right: the uterine natural killer (uNK) cell clusters are visibly smaller in the diagnosed group, while the B cell cluster is larger.
Figure 3. Maps of individual cells recovered from menstrual effluent, with controls on the left and people diagnosed with endometriosis on the right: the uterine natural killer (uNK) cell clusters are visibly smaller in the diagnosed group, while the B cell cluster is larger.Figure 3 from Shih et al., BMC Medicine (2022), CC BY 4.0.
Figure 4 from Single-cell menstrual tissue in endometriosis: For each cell type, how much more or less common it was in menstrual effluent from people with endometriosis compared with controls: uterine natural killer cells were less common in endometriosis, and B cells were the most enriched.
Figure 4. For each cell type, how much more or less common it was in menstrual effluent from people with endometriosis compared with controls: uterine natural killer cells were less common in endometriosis, and B cells were the most enriched.Figure 4 from Shih et al., BMC Medicine (2022), CC BY 4.0.

Figures reproduced unchanged from Shih AJ et al., BMC Medicine, 2022, under CC BY 4.0. Captions written by Qvin.

How to cite

Shih AJ, Adelson RP, Vashistha H, Khalili H, Nayyar A, Puran R, et al. Single-cell analysis of menstrual endometrial tissues defines phenotypes associated with endometriosis. BMC Medicine. 2022;20(1):315. doi:10.1186/s12916-022-02500-3

Reviewed by the Qvin science team, .