Endometrial stromal cell signaling and microRNA exosome content in women with adenomyosis

To our knowledge, this is the first foundational study to comprehensively isolate and characterize stroma-derived exosomes from women with adenomyosis. Exosome isolation by means of differential ultracentrifugation was validated in 22 samples, including 11 healthy subjects and 11 women with adenomyosis, using nanoparticle tracking analysis, transmission electron microscopy and flow cytometry. MicroRNA profiling in secreted exosomes revealed 10 microRNAs with altered expression in adenomyosis subjects during the menstrual phase compared to controls.

Thorough investigations into menstruation-specific molecular mechanisms as well as predicted target genes and enriched pathways of exosomal microRNAs offer promising insights into the pathogenesis of adenomyosis, shedding light on the potential mechanisms underlying stromal cell signaling and adenomyotic lesion establishment. This groundwork study does, however, have certain limitations, including sample size and limited representation due to a lack of readily available endometrial biopsies in the menstrual phase.

Future research should seek to validate these findings in larger cohorts and apply functional assays to clarify the role of menstruation-specific stroma-derived microRNA-mediated signaling and its potential impact on adenomyosis development.