Circulating tRNA-derived fragments in women with endometriosis: a pilot study

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Small RNA sequencing of serum from women with endometriosis identified a distinct circulating tRF signature that differentiates patients from controls and aligns with baboon models, suggesting potential as noninvasive diagnostic biomarkers.

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This pilot study analyzed serum samples from eleven women to identify circulating transfer RNA-derived fragments (tRFs) as potential non-invasive biomarkers for endometriosis. Using small RNA sequencing and differential expression analysis, the researchers identified 82 significantly altered tRFs that distinguished patients with the disease from controls with other benign gynecologic conditions. Several of these dysregulated fragments showed concordant expression patterns with a previously reported baboon model of endometriosis, and ROC analyses indicated that specific tRFs, such as tRF-19-WB8US5IU, possessed high discriminatory performance with an area under the curve of 0.96. The authors note limitations including the small sample size, lack of functional validation, and absence of menstrual cycle phase correction in controls. This paper is centrally about endometriosis — specifically the discovery and diagnostic potential of circulating tRF signatures in blood serum.

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References

Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;397:839–52. https://doi.org/10.1016/S0140-6736(21)00389-5. Hu Y, Cai A, Xu J, Feng W, Wu A, Liu R, et al. An emerging role of the 5’ termini of mature tRNAs in human diseases: current situation and prospects. Biochim Biophys Acta Mol Basis Dis. 2022;1868:166314. https://doi.org/10.1016/j.bbadis.2021.166314. Li WS, Li YL, Cao R, Ha CF, Sun S, Yu L, et al. Differential expression and bioinformatics analysis of tRF/tiRNA in endometriosis patients. BioMed Res Int. 2022;2022:9911472. https://doi.org/10.1155/2022/9911472. Surmann H, Mamillapalli R, Joshi N, Burns G, Fazleabas AT, Taylor HS. Circulating transfer RNA-derived fragment abundance after experimental endometriosis induction in baboons. Mol Hum Reprod. 2026:32. https://doi.org/10.1093/molehr/gaag032. Moustafa S, Burn M, Mamillapalli R, Nematian S, Flores V, Taylor HS. Accurate diagnosis of endometriosis using serum microRNAs. Am J Obstet Gynecol. 2020;223:557.e551-557.e511. https://doi.org/10.1016/j.ajog.2020.02.050.

Acknowledgements

We thank Monish Kumar for depositing the data in the NCBI database. Funding This work was supported by grants from National Institutes of Health (NIH R01 HD100336) and the Endometriosis Foundation of America (AWD0003567). Author information Authors and Affiliations Contributions AVM recruitment of patients, blood collection, acquiring demographic data and read the manuscript. RM sample storage, performed experiments, acquired the data and supervision of the project. HS analyzed the data and wrote the initial draft of the manuscript. RM and HS prepared the figures. RM and HT conceptualization designed the study, methodology, reviewed and edited the manuscript. All authors read and approved the manuscript. Corresponding authors Ethics declarations Ethics approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki, and approved by Institutional Review Board of the Yale University, protocol # 1608018237. Informed consent was obtained from all individual participants included in the study, or from legal guardians as appropriate. Consent for publication Patients or their guardians, as appropriate, signed informed consent regarding publishing their data. Competing interests All authors declare that none of authors have any financial or non‐financial competing interests. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. About this article Cite this article Vash-Margita, A., Surmann, H., Mamillapalli, R. et al. Circulating tRNA-derived fragments in women with endometriosis: a pilot study. Mol Biomed 7, 238 (2026). https://doi.org/10.1186/s43556-026-00629-8 Received: Revised: Accepted: Published: Version of record: DOI: https://doi.org/10.1186/s43556-026-00629-8

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