Proteomic profiling analysis of human endometrium in women with unexplained recurrent spontaneous abortion

Unexplained recurrent spontaneous abortion (URSA) seriously affects female reproductive health, which has caused a great burden to patients both physically and mentally. Endometrial decidualization plays an important role in pregnancy, and impaired decidualization is an essential cause of URSA, but the cause of the damage is still poorly studied. This study intended to reveal the pathogenesis of URSA by analyzing the differential protein expression profiles in the decidual tissue of recurrent abortion patients and normal pregnancy patients. Morphological analysis revealed abnormal decidualization of endometrial tissue in patients with URSA. Quantitative proteomics analysis showed that a total of 146 differentially expressed proteins were identified between the two groups, among which 95 proteins were downregulated and 51 proteins were upregulated. Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways revealed that the protein expression profile and signaling pathways of endometrium in patients with URSA changed significantly, and cytoskeleton remodeling and morphological transformation disorders were associated with abortion induced by incomplete decidualization. Meanwhile, transcription factors analysis showed that the 3 most affected families were zf-C2H2, MYB and HMG. Therefore, our study may provide a basis for searching for potential markers of decidualization injury. At present, there are still about 50% of RSA patients with unknown causes, which brings great difficulties and blindness to clinical diagnosis and treatment. Until now, there are still few proteomic studies on URSA. This study focused on proteomic profiling analysis of human endometrium in women between URSA patients and normal women. We found cytoskeletal remodeling disorder is the main cause of decidualization failure in URSA patients.