Multi-Omics based mapping of Decidualization Resistance in patients with a history of Severe Preeclampsia

In this study, we investigated endometrial samples from different cohorts of non-pregnant women who had a previous sPE pregnancy compared to those with a normal pregnancy applying digital image analysis of hematoxylin and eosin (H&E) sections. For digital image analysis, endometrial tissue sections from former sPE (n=11) and control (n=9) patients were analysed. For scRNA seq, 11 cases and 12 controls were investigated. For spatial transcriptomics, 8 sPE cases and 8 controls and for the proteomics analysis, 7 sPE and 10 controls. All human endometrial samples of this study were collected in University and Polytechnic La Fe Hospital, Valencia, Spain and pass their Clinical Research Ethics Committee. Samples were collected from women aged 18-40 without any medical condition who had been pregnant 1-8 years earlier. All donors had regular menstrual cycles (25-31 days) without underlying pathological condition and had no received hormonal therapy in the 3 months preceding sample collection. Endometrial samples were analysed by digital morphologycal analysis, single-cell RNA sequencing, spatial transcriptomics and laser capture microdissection coupled mass spectrometry. Our present study offers a comprehensive exploration of the decidualization resistance condition in former sPE patients, shedding light on the associated changes at gross, microscopic, scRNA seq, spatial transcriptomics and proteomics by LCM-MS.