Global alteration in gene expression profiles of deciduas from women with idiopathic recurrent pregnancy loss

S. A. Krieg, X. Fan, Y. Hong, Q. X. Sang, A. Giaccia, L. M. Westphal, R. B. Lathi, A. J. Krieg, N. R. Nayak

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Recurrent pregnancy loss (RPL) occurs in ~5% of women. However, the etiology is still poorly understood. Defects in decidualization of the endometrium during early pregnancy contribute to several pregnancy complications, such as pre-eclampsia and intrauterine growth restriction (IUGR), and are believed to be important in the pathogenesis of idiopathic RPL. We performed microarray analysis to identify gene expression alterations in the deciduas of idiopathic RPL patients. Control patients had one antecedent term delivery, but were undergoing dilation and curettage for current aneuploid miscarriage. Gene expression differences were evaluated using both pathway and gene ontology (GO) analysis. Selected genes were validated using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). A total of 155 genes were found to be significantly dysregulated in the deciduas of RPL patients (>2-fold change, P < 0.05), with 22 genes up-regulated and 133 genes down-regulated. GO analysis linked a large percentage of genes to discrete biological functions, including immune response (23%), cell signaling (18%) and cell invasion (17.1%), and pathway analysis revealed consistent changes in both the interleukin 1 (IL-1) and IL-8 pathways. All genes in the IL-8 pathway were up-regulated while genes in the IL-1 pathway were down-regulated. Although both pathways can promote inflammation, IL-1 pathway activity is important for normal implantation. Additionally, genes known to be critical for degradation of the extracellular matrix, including matrix metalloproteinase 26 and serine peptidase inhibitor Kazal-type 1, were also highly up-regulated. In this first microarray approach to decidual gene expression in RPL patients, our data suggest that dysregulation of genes associated with cell invasion and immunity may contribute significantly to idiopathic recurrent miscarriage.

Original languageEnglish (US)
Article numbergas017
Pages (from-to)442-450
Number of pages9
JournalMolecular Human Reproduction
Issue number9
StatePublished - Sep 2012
Externally publishedYes


  • Decidua
  • Interleukin-1
  • Interleukin-8
  • Matrix metalloproteinases
  • Recurrent miscarriage

ASJC Scopus subject areas

  • Medicine(all)


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