Evidence map›Paper›PMID 42010552›Full record

ArticleBMC women's health2026

Integrated single-cell and spatial transcriptomics reveal divergent immunological and stromal programs in peritoneal versus ovarian endometriosis.

Fangjie He, Shuiling Zu, Yan Lin, Jun Shi, Shunhe Lin

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In one paragraph

Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Fangjie He *Department of Gynecology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350000, China. dr_hefangjie@163.com.ORCID 0000-0002-3628-2324
Shuiling Zu *Department of Gynecology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350000, China.
Yan Lin *Department of Ultrasound, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350000, China.
Jun ShiDepartment of Gynecology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350000, China.
Shunhe LinDepartment of Gynecology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Maternity and Child Health Hospital, Fujian Medical University, Fuzhou, 350000, China. lsh2816@sina.com.ORCID 0000-0002-8626-9152

Funding

Fujian Provincial Health Technology Project 2024GGA057Joint Funds for the Innovation of Science and Technology, Fujian Province 2023Y9359Joint Funds for the Innovation of Science and Technology, Fujian Province 2024Y9538Qihang Fund of Fujian Medical University 2023QH1190Qihang Fund of Fujian Medical University 2023QH1193
6 · The paper itself

Abstract

backgroundEndometriosis encompasses heterogeneous lesions, primarily peritoneal and ovarian subtypes, with distinct immunological and fibrotic features. The subtype-specific roles of the immune microenvironment in pathogenesis remain unclear. Integrated analysis combining high-resolution cellular atlases with spatial context is needed to decipher these mechanisms.

methodsWe performed an integrative analysis of published single-cell RNA sequencing (n = 81,676 cells) from control endometrium (Ctrl), eutopic endometrium (EuE), peritoneal endometriosis (EcP), and ovarian endometriosis (EcO), and spatial transcriptomic (n = 60 segments) data from Ecp and match EuE. Analytical pipelines include cellular atlas construction, differential expression, spatial co-expression, and cell-cell communication inference.

resultsOur single-cell atlas revealed fundamentally distinct cellular ecosystems. EcP was enriched for CCL19 + perivascular cells (6.4-fold vs. control) and immune-active niches, whereas EcO exhibited pronounced smooth muscle differentiation and NNMT upregulation. Spatial analysis compartmentalized these programs, with the CCL19-CCR7 chemokine axis localized to stromal niches in EcP strongly correlated (ρ = 0.872). In contrast, EcO showed enhanced smooth muscle gene expression (MYH11, log₂FC = 3.87). Cell-cell communication networks diverged, with EcP dominated by chemokine and TGF-β signaling, and EcO dominated by smooth muscle and PDGF pathways. Therapeutic target analysis revealed subtype-specific patterns: immune checkpoints (CTLA4 and PDCD1) were upregulated in EcP, whereas MMP9 was dramatically downregulated in EcO.

conclusionEcP and EcO exhibit fundamentally divergent programs. We propose to conceptualize these as an ‘immune-hot’, chemokine-driven inflammatory niche (EcP) versus an ‘immune-cold’, fibromuscular survival niche (EcO). These findings underscore that lesion-specific immune-stromal crosstalk may dictates pathogenesis and suggest a potential paradigm shift toward immunologically-informed, subtype-specific precision therapeutics, which warrant further experimental validation.

Indexed as

EndometriosisOvarian DiseasesPeritoneal DiseasesEndometriumFemaleHumansSingle-Cell AnalysisSingle-Cell Gene Expression AnalysisSpatial TranscriptomicsStromal CellsTranscriptomeCCL19-CCR7 axisEndometriosisImmune-cold nicheImmune-hot nichePrecision medicineSingle-cell RNA sequencingSpatial transcriptomics

Identifiers

PMID42010552
PMCPMC13224674

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.