Title: Transcriptomics and proteomics reveal associations between myometrium and
intrauterine adhesions
Version: 4 Date: 05 Jan 2025
Reviewer:  Marco la Verde
Reviewer's report:
Dear Authors,
Appreciative, thanks are due to your giving me the chance of going through the revised
version of your manuscript with the title: "Transcriptomics and Proteomics Reveal Associations
Between Myometrium and intrauterine Adhesions"; this is important in gynaecological circles
to identify the pathogenesis of intrauterine adhesions by availing state-of-the-art approaches in
transcriptomics and proteomic methodologies.
While the manuscript has merit, there are aspects in it that need major revisions in order to
improve scientific merit, clarity, and access of the work.
Recommendations
Abstract
1Further, the results and conclusions must be simplified to disclose the main findings in fewer
words.
2Clearly state the levels of significance of observed changes (e.g., P-values) when applicable.
3Highlight potential clinical applications that could be translated from your findings.
Introduction
4The biological functions of the inner myometrium and the junctional zone might explain their
respective roles in the development of IUA.
5A clear, testable hypothesis should be included in order to make the study's objectives explicit.
6Authors repoted this sentece: "The repair process involves three brief and overlapping phases:
inflammatory phase, tissue formation phase, and tissue remodeling phase. " No one reference
was added, i recommend to support this sentence to cite novel article about the uterine
Hysteroscopic Metroplasty, that represent a cause of the IUA:
https://doi.org/10.1016/j.ajog.2016.05.001
https://doi.org/10.1016/j.jmig.2012.09.010
https://doi.org/10.1016/j.jogoh.2020.101763
Methods
7More details about the inclusion and exclusion criteria should be given, in particular for the
control group. 8Actually, how was normal myometrium considered "normal"?
9Define the criteria for selecting differentially expressed genes and proteins. Were thresholds
for fold change and P-values applied consistently?
10Discussion on whether the findings of the transcriptomic and proteomic analyses were
validated by independent experimental methods and how.
Results
11 Improve figure quality; all figures should be self-contained, with a full legend. Where
appropriate and given the complexity, consideration of pathway enrichment and interaction of
genes/proteins can be considered by intuitive visualizations.
12 Present statistical values (such as means ± SD, confidence intervals) in conjunction with P-
values, so that the interpretation of data can be performed.
13 Provide information on the biological function of genes discussed in the context of pathways,
including for example KIF14, CIT, and complement components. Which of these is more
mechanistically plausible to you as contributing to either fibrosis or adhesion formation?
Discussion
14Mechanistic links between the observed transcriptomic/proteomic changes and IUA
pathology should be elaborated. Findings can also be contextualized with previous studies.
15 Explicitly state how your results might influence diagnostic or therapeutic strategies for IUA.
16 The discussion of limitations should be framed in terms of sample size, reliance on
bioinformatic analyses, and the absence of functional validation experiments.
17 Say what follow-on experiments or clinical trials could be done based on your findings.
Language and Style
18All grammatical errors and awkward phrasings were corrected throughout the manuscript. A
professional language edit is recommended for better readability.
19Watch out for consistency in the use of technical terms. For example, "inner myometrium"
is better than "junctional zone.".
20Define all acronyms at their first mention, and use consistently.
Conclusion: Your manuscript significantly contributes to the understanding of the pathogenesis
of IUA but needs major revisions if it is to meet the standards expected of high-impact scientific
journals. You could improve the scientific quality of your work along with its presentation by
addressing the concerns mentioned above.
Thank you for considering the remark. I look forward to going through the revised version of
your manuscript. Best regards,