Study On The Abnormally Expressed Genes And Their Basic Mechanisms In The Decidua Tissue Of Women With Recurrent Pregnancy Loss

Recurrent pregnancy loss(RPL)occurs in about 5% of women of childbearing age and affects more than 1.3 million women annually.’There are currently more than 50% of RPL in clinical practice that cannot be determined with a clear cause.This will lead to a great psychological burden for female patients of childbearing age who desire to have healthy offspring.Normal pregnancy requires the environment of the mother’s uterus to maintain a steady state,and the dysfunction of the mother’s decidua may cause RPL.When RPL occurs,what changes have occurred in the maternal decidual tissue at the molecular level,there is still a lack of relevant research.In the current study,we first used RNA-seq to describe the molecular environment of the decidual tissue of RPL women.We found that in the decidua tissue of RPL women,the expression levels of 153 genes are different from those of normal pregnant women,including 69 genes with increased expression and 84 genes with decreased expression.We then carried out GO and KEGG pathway enrichment analysis on these differentially expressed genes to identify possible RPL-related biological processes.We found that the type Ⅰ interferon signaling pathway and TNF signaling pathway were significantly activated in RPL patients.Through q RT-PCR,15 RPL patients and 12 control women were recruited to confirm that the expression of the downstream genes,MX1,IFI27,and ISG15,in the type Ⅰ interferon signaling pathway are up-regulated,and the expression of TNFRSF21 in the TNF signaling pathway is up-regulated.We then explored the function of TNFRSF21 on normal human primary endometrial stromal cells,and the possible influence of type Ⅰ interferon signaling pathway activation.We found that the activation of type Ⅰ interferon signaling pathway and the increased expression of TNFRSF21 gene can increase the level of endometrial stromal cell apoptosis.Since the activation of the typeⅠinterferon signaling pathway often means the presence of bacterial/viral infection in the uterine cavity,our results suggest that for RPL patients,the intrauterine infection can be considered as a pathogenic factor.