Title: Transcriptomics and proteomics reveal associations between myometrium and
intrauterine adhesions
Version: 3 Date: 01 Dec 2024
Reviewer:  Marco la Verde
Reviewer's report:
Dear Authors,
Your manuscript covered a big and complex theme, important for the improvement of our
knowledge on intrauterine adhesions. However, without further improvement regarding clarity,
scientific detail profundity, and presenting one more major proposal, the following has been
outlined:
Title and Abstract
1.Title Improvement: The title should be short but right to the point, based on either a central
hypothesis or findings.
2.Abstract: Too general, lacks specifics in methods and main results.
3.The abstract's conclusion should be rewritten to provide a look at the new insights derived
from the research.
Introduction
4. Knowledge gap: The introduction points toward the challenges related to IUA, though the
statement how your research fits into existing studies should be more articulate. Consider
revising introductory background, briefly setting up the bases for inner myometrium in IUA.
5. Literature Citations: Most of the key references are either outdated or should be updated with
recent ones on the relevant field of uterine pathologies for placing your proposed approach in
context. I suggest to cite:
https://doi.org/10.1016/j.jmig.2020.06.030
https://doi.org/10.1080/13697137.2020.1754390
https://doi.org/10.1016/j.ajog.2021.09.015
6Materials and Methods. Details on Patient Cohort. Tissues were sampled from cases and
controls, but both are referred to as having various features. Comment on identical tissue
handling across all the cases included in the study.
7. Justify the age range and inclusion criteria of the study. For instance, why has the age been
limited to between 20-35 years?
8. Transcriptomic and proteomic methodologies: The latter regarding the experimental design
is indicated, but the technical replications for the reproduction of these omics data could
indicate just a little more about why and how the variability throughout among the samples was
minimized at lowest ranges before replicate consideration.
9. Results: Presentation of Data: Informative visualizations here ; however, they need further
elaboration in the text. In other words, for every figure, please make sure after the figure the key
message comes explicitly in the text.
10. Relating Results: Further discussion of how your transcriptomics and proteomics data relate
to each other would be much appreciated, since that is a big strength in this study.
12.Prioritization during discussion was given to some markers such as CIT and KIF14.
13.Discussion: The section needs more contextualization in teasing out the ways that the findings
extend existing knowledge on the process of IUA pathogenesis and therapeutic targets. To better
understand the uterine pathologies I reccomend to cite relevant articles:
 https://doi.org/10.3390/medicina60010064
10.1097/GCO.0b013e328359f10a
14. Address any data that may have emerged as conflicting from previous studies and interpret
such results in a balanced manner.
15. Study Limitations: While limitations are provided, the detail is needed-especially in regard
to the lack of normal endometrial tissue as a control. Comment on the implications this has for
interpreting your findings.
16.Future Directions, Pathway Validation: Include proposed or designed experiments in the
manuscript that will aid in the validation of such critical pathways, either using knockdown
models or even functional assays. Suggest how this might translate into clinical interventions
to manage or prevent IUA.
Although the manuscript gives insight into a number of points, huge improvement is really
needed regarding data presentation, methodological stringency, and coherence in narration. If
due attention is paid to these revisions, your paper will be much more readable and of better
impact.
Sincerely,