P-335 Integrative analysis of endometriosis and adenomyosis through single-cell transcriptomics
Authors: Rytkönen K , Zuniga Norman S , Elo L  L , Poutanen M 
Published: July 2024

Abstract

Study question
What are the shared and unique cell type -specific molecular pathways in endometriosis and adenomyosis?

Summary answer
Our analysis focuses on hormonal pathways and those regulating cell proliferation and apoptosis, which are crucial for the persistence of the lesions.

What is known already
Estrogen-driven proliferation and progesterone unresponsiveness are key mechanisms in the pathogenesis of endometriosis and adenomyosis. It has been recently observed that core pathways governing proliferation and apoptosis, such as the Wnt/beta-catenin and KRAS pathways, are involved in the etiology. The precise mechanisms of how estrogen and progesterone signaling interact with the Wnt/beta-catenin and KRAS pathways, which contribute to lesion growth maintenance, are not fully understood, but preliminary evidence suggests some level of cross-talk in both conditions.

Study design, size, duration
Although endometriosis and adenomyosis share similar mechanisms, they have mostly been studied in isolation. We propose a comprehensive study using an integrated approach to gain a deeper understanding of their pathophysiology. We will combine recent single-cell study data from both disorders, and examine the shared and unique cell-type-specific molecular pathways diverging from the eutopic endometrium.

Participants/materials, setting, methods
We will employ publicly available single-cell transcriptomic data from cases of endometriosis, adenomyosis, and controls with eutopic endometrium. Tissue sections from an extensive collection of patient samples will be examined for validation.

Main results and the role of chance
We will integrate single-cell transcriptomic data for endometriosis, adenomyosis, and eutopic endometrium controls. For each cell type, we will conduct comprehensive differential expression analysis between lesions and endometrium, study cell-to-cell communication among major cell types, and construct gene regulatory networks that are either shared or specific to endometriosis and adenomyosis. We will also consider GWAS lead genes and investigate their cell type-specific expression, focusing on hormonally regulated genes. Tissue sections of patient samples, apoptosis measurements, and clinical parameters including pain data will be utilized for validation.

Limitations, reasons for caution
The public single-cell transcriptomic data for endometriosis and adenomyosis have limitations in sample size and menstrual cycle distribution. The utilized single-cell transcriptomics data and the in-house tissue collections for validations studies are not matched.

Wider implications of the findings
This project aims to identify molecular pathways in endometriosis and adenomyosis, potentially revealing common disease development mechanisms and unique molecular signatures. Both endometriosis and adenomyosis are significant health issues affecting women, and their study contributes to the broader understanding of women’s health.

Trial registration number
not applicable