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Massive infiltrated and enriched decidual macrophages (dMφ) have been widely regarded as important regulators of maternal-fetal immune tolerance and trophoblast invasion, contributing to normal pregnancy. However, the characteristics of metabolic profile and the underlying mechanism of dMφ residence remain largely unknown. Here, we observe that dMφ display an active glycerophospholipid metabolism. The activation of ENPP2-lysophosphatidic acid (LPA) facilitates the adhesion and retention, and M2 differentiation of dMφ during normal pregnancy. Mechanistically, this process is mediated through activation of the LPA receptors (LPAR1 and PPARG/PPARγ)-DDIT4-macroautophagy/autophagy axis, and further upregulation of multiple adhesion factors (e.g., cadherins and selectins) in a CLDN7 (claudin 7)-dependent manner. Additionally, poor trophoblast invasion and placenta development, and a high ratio of embryo loss are observed in , or PPARG-blocked pregnant mice. Patients with unexplained spontaneous abortion display insufficient autophagy and cell residence of dMφ. In therapeutic studies, supplementation with LPA or the autophagy inducer rapamycin significantly promotes dMφ autophagy and cell residence, and improves embryo resorption in and spontaneous abortion mouse models, which should be dependent on the activation of DDIT4-autophagy-CLDN7-adhesion molecules axis. This observation reveals that inactivation of ENPP2-LPA metabolism and insufficient autophagy of dMφ result in resident obstacle of dMφ and further increase the risk of spontaneous abortion, and provides potential therapeutic strategies to prevent spontaneous abortion. ACTB: actin beta; ADGRE1/F4/80: adhesion G protein-coupled receptor E1; Atg5: autophagy related 5; ATG13: autophagy related 13; BECN1: beclin 1; CDH1/E-cadherin: cadherin 1; CDH5/VE-cadherin: cadherin 5; CFSE: carboxyfluorescein succinimidyl ester; CLDN7: claudin 7; CSF1/M-CSF: colony stimulating factor 1; CSF2/GM-CSF: colony stimulating factor 2; Ctrl: control; CXCL10/IP-10: chemokine (C-X-C) ligand 10; DDIT4: DNA damage inducible transcript 4; dMφ: decidual macrophage; DSC: decidual stromal cells; ENPP2/ATX: ectonucleotide pyrophosphatase/phosphodiesterase 2; : heterozygous knockout mouse; ENPP2i/PF-8380: ENPP2 inhibitor; EPCAM: epithelial cell adhesion molecule; ESC: endometrial stromal cells; FGF2/b-FGF: fibroblast growth factor 2; GAPDH: glyceraldehyde-3-phosphate dehydrogenase; GPCPD1: glycerophosphocholine phosphodiesterase 1; HE: heterozygote; HIF1A: hypoxia inducible factor 1 subunit alpha; HNF4A: hepatocyte nuclear factor 4 alpha; HO: homozygote; ICAM2: intercellular adhesion molecule 2; IL: interleukin; ITGAV/CD51: integrin subunit alpha V; ITGAM/CD11b: integrin subunit alpha M; ITGAX/CD11b: integrin subunit alpha X; ITGB3/CD61: integrin subunit beta 3; KLRB1/NK1.1: killer cell lectin like receptor B1; KRT7/cytokeratin 7: keratin 7; LPA: lysophosphatidic acid; LPAR: lysophosphatidic acid receptor; : homozygous knockout mouse; LPAR1i/AM966: LPAR1 inhibitor; LY6C: lymphocyte antigen 6 complex, locus C1; LYPLA1: lysophospholipase 1; LYPLA2: lysophospholipase 2; : lysozyme 2; MAP1LC3B: microtubule associated protein 1 light chain 3 beta; MARVELD2: MARVEL domain containing 2; 3-MA: 3-methyladenine; MBOAT2: membrane bound O-acyltransferase domain containing 2; MGLL: monoglyceride lipase; MRC1/CD206: mannose receptor C-type 1; MTOR: mechanistic target of rapamycin kinase; NP: normal pregnancy; PDGF: platelet derived growth factor; PLA1A: phospholipase A1 member A; PLA2G4A: phospholipase A2 group IVA; PLPP1: phospholipid phosphatase 1; pMo: peripheral blood monocytes; p-MTOR: phosphorylated MTOR; PPAR: peroxisome proliferator activated receptor; PPARG/PPARγ: peroxisome proliferator activated receptor gamma; PPARGi/GW9662: PPARG inhibitor; PTPRC/CD45: protein tyrosine phosphatase receptor type, C; Rapa: rapamycin; RHEB: Ras homolog, mTORC1 binding; SA: spontaneous abortion; SELE: selectin E; SELL: selectin L; si-silenced; STAT: signal transducer and activator of transcription; SQSTM1: sequestosome 1; TJP1: tight junction protein 1; VCAM1: vascular cell adhesion molecule 1; WT: wild type.
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http://dx.doi.org/10.1080/15548627.2022.2039000 | DOI Listing |
Medicine (Baltimore)
September 2025
Department of Ultrasound, Hangzhou Women's Hospital, Hangzhou, Zhejiang Province, P. R. China.
Rationale: Sepsis following hysteroscopy is an rare complication, with current evidence suggesting that routine prophylactic antibiotic administration may not be warranted. However, this does not imply that we should disregard vigilance regarding the potential occurrence of severe infections post-hysteroscopy.
Patient Concerns: A 27-year-old female underwent hysteroscopic resection of retained products of conception after incomplete medical abortion.
Trop Doct
September 2025
Associate Professor, Department of Paediatrics, All India Institute of Medical Sciences, Bibinagar, India.
Scrub typhus, caused by , is a zoonotic infection endemic to the Asia-Pacific region. Its severity ranges from mild illness to life-threatening complications and case fatality rate upto 30%, highlighting the importance of early diagnosis. This study analyzed the clinical profile and pregnancy outcomes of 34 pregnant women diagnosed with scrub typhus at a tertiary care and referral centre.
View Article and Find Full Text PDFBiol Trace Elem Res
September 2025
State Key Laboratory of Swine and Poultry Breeding Industry, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, 611130, China.
Ferroptosis is a form of iron-regulated cell death that plays a critical role in various aspects of female reproductive system development. These processes include the normal estrous cycle, ovarian formation, follicular maturation, ovulation, and pregnancy, all of which are essential for maintaining reproductive health in female animals. However, excessive iron leads to the accumulation of reactive oxygen species within cells, disrupting intracellular redox balance, inducing mitophagy, membrane rupture, and lipid peroxidation, which can damage tissues and cells, ultimately resulting in ferroptosis.
View Article and Find Full Text PDFDrug Target Insights
August 2025
Department of Gynecology, Shanghai University of Traditional Chinese Medicine affiliated Shuguang Hospital Anhui Hospital, Anhui, Hefei - China.
Introduction: Bushenhuoxue formula is a traditional Chinese medicine formula with relatively safe clinical effects, but its mechanism in recurrent spontaneous abortion (RSA) is still unclear. Our present study used Network pharmacology an experimental validation to discuss how Bushenhuoxue formula improves prethrombotic state in RSA.
Materials And Methods: The active ingredients of Bushenhuoxue formula (Drug) were acquired from our previous study.
Int J Womens Health
September 2025
Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.
Background: Female reproductive disorders (FRDs) are common diseases among women of childbearing age, affecting their reproductive health. Age at first sexual intercourse (AFS) is potentially linked to FRDs, and this study aims to investigate these associations and underlying mechanisms, to offer new insights and guidance for sex education in adolescent women and reproductive health management.
Methods: Mendelian randomization (MR) analysis was performed using summary data from genome-wide association studies (GWASs).