Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse

Abstract

Pelvic organ prolapse (POP) markedly affects the quality of life of women, including significant financial burden. Different cell types and corresponding marker genes were identified in the vaginal wall of women with POP; however, no study has explored gene expression and cellular heterogeneity in the uterosacral ligament. Using single-cell RNA sequencing, we constructed a transcriptional profile of the uterosacral ligament and control samples, and identified 10 major cell types. We performed subpopulation analysis of POP primary cells, explored differentially expressed genes, and performed pseudo-time and transcription factor analyses. We verified previous cell clusters of human fibroblasts, neutrophils, and found new clusters of uterosacral ligaments. Additionally, we dissected pattern changes of cell–cell interaction between stromal and immune cells and transcription factors related to the extracellular matrix, development, and immunity in POP. Here we provide insight into the molecular mechanisms of POP and valuable information for future research directions.