Chang-Hoon Cho: A Comprehensive Immune Atlas of the Human Endometrium
Chang-Hoon Cho, Executive Consultant at Medical PIS, shared on LinkedIn about a paper by Lingtao Yang et al. published in Nature Communications:
”The endometrium prepares for pregnancy by remodeling its immune system, and lymphoid aggregates can derail it.
Researchers constructed a comprehensive immune atlas of the human endometrium by profiling 53 healthy women and 34 patients with chronic endometritis (CE) across precisely staged menstrual cycle phases.
The study reveals that endometrial immunity is continuously remodeled as the tissue prepares for embryo implantation.
NK and T cells were the dominant immune populations.
From the proliferative to secretory phase:
- NK cells progressively increased
- T cells progressively decreased
- B cells, mast cells, and innate lymphoid cells remained consistently rare
Among two tissue-resident NK cell subsets, CD11c⁺ NK cells accumulated during the secretory phase and early pregnancy, identifying a specific immune trajectory associated with preparation for implantation.
Chronic endometritis profoundly disrupted this landscape.
Key Mechanism
- Chronic endometritis
- CD11c⁺ NK cells
- Local B cell proliferation and differentiation
- Germinal-center-B-like cells + T follicular helper-like cells
- Ectopic lymphoid aggregates
- Tfh-like-cell-dependent impairment of pregnancy outcomes
Using both a murine CE model and a subsequent multicenter cohort study, the researchers demonstrated that these lymphoid aggregates compromise pregnancy outcomes and may serve as a prognostic indicator of pregnancy failure.
This work provides a physiological reference map of immune remodeling across the menstrual cycle and identifies a pathogenic mechanism linking chronic endometritis, ectopic lymphoid organization, and pregnancy failure.
It also raises the possibility that targeting the Tfh-like cell – B cell axis or identifying pathological lymphoid aggregates could enable more precise management of immune-mediated reproductive disorders.”
Title: An endometrial immune atlas across the female menstrual cycle reveals lymphoid aggregates compromise pregnancy
Authors: Lingtao Yang, Jing Yang, Yuye Li, Yiyi Su, Huan Ma, Songchen Cai, Meilan Mo, Lijun Ding, Chunyu Huang, Fenghua Liu, Aiping Qin, Alexandra P. Bielfeld, Udo R. Markert, Shuyi Yu, Linlin Wang, Ruochun Lian, Fu Hang, Wenjuan Liu, Elizabeth Soczewski, Astrid Schmidt, Jana Pastuschek, Dunja M. Baston-Buest, Nengming Xiao, Kairui Mao, Hao Wang, Xiaoyan Chen, Zhenwei Lan, Yuying Zhang, Tailang Yin, Wanze Chen, Xiaoshan Shi, Shuangyin Wang, Fan Yang, Haixiang Sun, Yong Zeng, Qiyuan Li, Lianghui Diao and Hanjie Li.
You can read the Full Article in Nature Communications.
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