Decidual macrophage-mediated ferroptosis in trophoblasts leads to recurrent spontaneous abortion
Xin Chen, Xueqin Ma, Pengcheng Pang, Heng Zhou, Ruohan Li, Yan He, Yan Zhang, Jing Yang, Qianlin Song, Qingsong Ye
Journal:iMeta
IF:44.4
DOI:10.1002/imt2.70138
PMID:
Published:2026-06-14
research field:细胞生物学免疫学生殖免疫学发育生物学妇产科学分子医学
Abstract
Recurrent spontaneous abortion (RSA) poses a significant challenge to successful early pregnancy, and trophoblast cell ferroptosis is an important pathogenic mechanism of RSA. However, it remains unclear whether decidual macrophages, as key immune regulators at the maternal–fetal interface, participate in the regulation of ferroptosis in trophoblast cells. This study observed significant ferroptosis in the placental trophoblast cells of patients with RSA and aborted mice. Transcriptomic sequencing results revealed that decidual macrophages derived from patients with RSA significantly promoted trophoblast cell ferroptosis while simultaneously impairing trophoblast cell function. Mechanistically, silencing heme oxygenase 1 (HMOX1) in trophoblast cells effectively reversed ferroptosis and restored trophoblast cell function, which was inhibited by decidual macrophages derived from patients with RSA. Notably, decidual macrophages regulate trophoblast ferroptosis and function by secreting C‐X‐C motif chemokine ligand 2 (CXCL2). Furthermore, the nuclear factor kappa‐B (NF‐κB) pathway was significantly enriched in trophoblast cells co‐cultured with decidual macrophages derived from patients with RSA. Further reversal experiments indicated that the CXCL2/NF‐κB/HMOX1 signaling axis may be a crucial mechanism by which decidual macrophages regulate trophoblast cell ferroptosis and function in RSA. Our subsequent findings demonstrated that trophoblast cells co‐cultured with RSA‐derived decidual macrophages promoted pro‐inflammatory polarization in macrophages. This effect was mediated by the interleukin‐6 (IL‐6) deficiency‐inhibited janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) signaling axis. Finally, pharmacological analysis revealed Eriodictyol exhibits CXCL2‐axis‐associated protective effects in RSA.
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