Uterus transplantation is being more widely implemented in clinical practice. Monitoring of rejection is routinely done for cervical biopsies and is dependent on histopathological assessment, as rejections are clinically silent and nonhistological biomarkers are missing. Until this gap is filled, it is important to corroborate the histopathological diagnosis of rejection through independent methods such as gene expression analysis. In this study, we compared our previously published scoring system for grading rejection in uterus transplant cervical biopsies to the gene expression profile in the same biopsy. For this, we used the Banff Human Organ Transplant gene panel to analyze the expression of 788 genes in 75 paraffin-embedded transplant cervical biopsies with a spectrum of histologic findings, as well as in 24 cervical biopsies from healthy controls. We found that gene expression in borderline changes did not differ from normal transplants, whereas the genes with increased expression in mild rejections overlapped with previously published rejection-associated transcripts. Moderate/severe rejection samples showed a gene expression pattern characterized by a mixture of rejection-associated and tissue injury–associated genes and a decrease in epithelial transcripts. In summary, our findings support our proposed scoring system for rejection but argue against the treatment of borderline changes.

中文翻译：

---

使用 Banff 人体器官移植面板对子宫移植宫颈活检进行转录分析


子宫移植在临床实践中得到更广泛的应用。宫颈活检常规进行排斥反应监测，并且取决于组织病理学评估，因为排斥反应在临床上没有反应，并且缺少非组织学生物标志物。在填补这一空白之前，重要的是通过基因表达分析等独立方法证实排斥反应的组织病理学诊断。在这项研究中，我们将我们之前发表的子宫移植宫颈活检排斥反应分级评分系统与同一活检中的基因表达谱进行了比较。为此，我们使用 Banff 人体器官移植基因面板分析了 75 例石蜡包埋移植宫颈活检中 788 个基因的表达，并分析了一系列组织学发现，以及来自健康对照的 24 例宫颈活检中的基因表达。我们发现临界变化中的基因表达与正常移植没有差异，而在轻度排斥反应中表达增加的基因与先前发表的排斥相关转录本重叠。中度/重度排斥反应样本显示基因表达模式，其特征是排斥反应相关基因和组织损伤相关基因的混合以及上皮转录物的减少。总之，我们的研究结果支持我们提出的拒绝评分系统，但反对对边缘变化的处理。