PCOS女性の子宮内膜の細胞アトラスが治療法の進展に寄与(Cell atlas of the endometrium in women with PCOS may lead to better treatment)

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2025-03-20 カロリンスカ研究所(KI)

カロリンスカ研究所の研究チームは、多嚢胞性卵巣症候群(PCOS)を持つ女性の子宮内膜の細胞地図を作成し、細胞組成や遺伝子発現の異常を明らかにしました。 PCOS患者の子宮内膜では、上皮細胞の割合が高く、間質細胞の割合が低いことが確認され、これが妊娠の難しさや流産のリスク増加、子宮内膜癌のリスクに関連している可能性があります。さらに、特定の細胞タイプでの遺伝子発現の乱れが、胚の着床障害や流産、子宮内膜癌に関連することが示されました。また、糖尿病治療薬メトホルミンの16週間の投与により、特に上皮細胞と間質細胞での遺伝子発現が正常化することが観察され、メトホルミンが血糖降下以外にも多くの機能を持つ可能性が示唆されました。これらの発見は、PCOS関連の子宮内膜機能障害に対する新たな治療法の開発に役立つと期待されています。

<関連情報>

多嚢胞性卵巣症候群におけるヒト子宮内膜の単一細胞プロファイリング Single-cell profiling of the human endometrium in polycystic ovary syndrome

Gustaw Eriksson,Congru Li,Tina Gorsek Sparovec,Anja Dekanski,Sara Torstensson,Sanjiv Risal,Claes Ohlsson,Angelica Lindén Hirschberg,Sophie Petropoulos,Qiaolin Deng & Elisabet Stener-Victorin
Nature Medicine  Published:20 March 2025
DOI:https://doi.org/10.1038/s41591-025-03592-z

PCOS女性の子宮内膜の細胞アトラスが治療法の進展に寄与(Cell atlas of the endometrium in women with PCOS may lead to better treatment)

Abstract

Polycystic ovary syndrome (PCOS) has a negative effect on the receptivity of the endometrium to embryo implantation and increases the risk of miscarriage and endometrial cancer. The cellular and molecular heterogeneity of the endometrium in women with PCOS has not been well studied. Our study presents a comprehensive cellular atlas of the endometrium during the proliferative phase in women with PCOS characterized by overweight and obesity, hyperandrogenism and insulin resistance compared with controls of similar age, weight and body mass index. Analysis of 247,791 isolated endometrial nuclei from 27 biopsies (5 controls and 12 PCOS cases at baseline and 7 after 16 weeks of metformin and 3 after lifestyle intervention) revealed cell-type-specific disease signatures and variations in cellular composition and localization. Samples taken after 16 weeks of metformin treatment and lifestyle management showed extensive recovery of disease-specific endometrial signatures. We linked the specific role of each cell type to clinical features such as hyperandrogenism and insulin resistance, and specific cell types to risk of endometrial and metabolic disease. In addition, potential therapeutic targets such as integrin inhibitors were identified and the role of metformin in restoring endometrial health in patients with PCOS was highlighted. Our findings lay the groundwork to significantly advance the understanding of PCOS-specific endometrial dysfunction for future targeted therapies.

医療・健康
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