# Immune-molecular nexus in reproductive disorders: mechanisms linking POI and RSA

**Authors:** Chen Chen, Xinyue Zhang, Wenxin Li, Yueqin Liu, Dan Zhao, Subo Zhang, Xiaolan Zhu

PMC · DOI: 10.3389/fgene.2025.1652519 · 2025-09-29

## TL;DR

This study explores the link between two reproductive disorders, POI and RSA, by identifying key genes and potential drugs using transcriptome data and machine learning.

## Contribution

The study identifies six hub genes and ten potential drugs for treating POI and RSA using integrated transcriptome data and machine learning.

## Key findings

- Six hub genes (CENPW, ENTPD3, FOXM1, GNAQ, LYPLA1, PLA2G4A) are linked to POI and RSA.
- Immune cell proportions, including activated NK cells, differ significantly in patients with these disorders.
- Ten potential drugs target key genes involved in metabolic pathways related to POI and RSA.

## Abstract

Infertility remains a prevalent global health concern, with Premature Ovarian Insufficiency (POI) and Recurrent Spontaneous Abortion (RSA) being common causes of female infertility.

This study aims to identify new central genes and potential therapeutic drugs for RSA and POI by integrating multi transcriptome data and machine learning algorithms.

This study utilized RNA sequencing data from patients with POI and RSA to identify key hub genes associated with these diseases. The analysis involved machine learning algorithms, mcode and Cytoscape, revealing important hub genes. The comprehensive evaluation includes functional annotation, protein-protein interaction (PPI) network, transcription factor (TF) gene regulatory network, microRNA (miRNA) gene regulatory network. Genome enrichment analysis (GSEA) and immune infiltration studies elucidated the potential mechanism between POI and RSA. Drug target enrichment analysis highlighted promising therapeutic agents against RSA and POI. Validation of granulosa cells and endometrial tissue samples using quantitative real-time polymerase chain reaction (qRT-PCR) highlighted the importance of the identified hub genes.

This study identified a total of six hub genes—— CENPW, ENTPD3, FOXM1, GNAQ, LYPLA1, and PLA2G4A. Immunoassay revealed an increase in activated NK cells. Furthermore, significant differences were observed in the proportions of other immune cell types, such as resting memory CD4 T cells, compared to the control group. Significantly, these six genes participate in diverse metabolic pathways linked to RSA and POI, particularly in oxidative phosphorylation, ribosome processes, and steroid biosynthesis pathways. Additionally, ten potential drugs (Rifabutin, Methaneseleninic Acid, Carbamazepine, Dasatinib,Troglitazone, Tamoxifen, Enterolactone, Anisomycin, Testosterone, 5-Fluorouracil) targeting key genes were identifed.

Targeting these genes shows promise for preventing and treating both POI and RSA, providing crucial insights into addressing these complex conditions at molecular level.

## Linked entities

- **Genes:** CENPW (centromere protein W) [NCBI Gene 387103], ENTPD3 (ectonucleoside triphosphate diphosphohydrolase 3) [NCBI Gene 956], FOXM1 (forkhead box M1) [NCBI Gene 2305], GNAQ (G protein subunit alpha q) [NCBI Gene 2776], LYPLA1 (lysophospholipase 1) [NCBI Gene 10434], PLA2G4A (phospholipase A2 group IVA) [NCBI Gene 5321]
- **Chemicals:** Methaneseleninic Acid (PubChem CID 161597), Carbamazepine (PubChem CID 2554), Dasatinib (PubChem CID 3062316), Troglitazone (PubChem CID 5591), Tamoxifen (PubChem CID 2733526), Enterolactone (PubChem CID 114739), Anisomycin (PubChem CID 31549), Testosterone (PubChem CID 6013), 5-Fluorouracil (PubChem CID 3385)

## Full-text entities

- **Genes:** ENTPD3 (ectonucleoside triphosphate diphosphohydrolase 3) [NCBI Gene 956] {aka CD39L3, HB6, NTPDase-3}, CENPW (centromere protein W) [NCBI Gene 387103] {aka C6orf173, CENP-W, CUG2}, GNAQ (G protein subunit alpha q) [NCBI Gene 2776] {aka CMAL, G-ALPHA-q, GAQ, SWS}, LYPLA1 (lysophospholipase 1) [NCBI Gene 10434] {aka APT-1, APT1, LPL-I, LPL1, hAPT1}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, PLA2G4A (phospholipase A2 group IVA) [NCBI Gene 5321] {aka GURDP, PLA2G4, cPLA2, cPLA2-alpha}, FOXM1 (forkhead box M1) [NCBI Gene 2305] {aka FKHL16, FOXM1A, FOXM1B, FOXM1C, HFH-11, HFH11}
- **Diseases:** RSA (OMIM:614389), reproductive disorders (MESH:D060737), POI (MESH:D016649), female infertility (MESH:D007247), Infertility (MESH:D007246), Spontaneous Abortion (MESH:D000022)
- **Chemicals:** Troglitazone (MESH:D000077288), Methaneseleninic Acid (MESH:C008493), Tamoxifen (MESH:D013629), Rifabutin (MESH:D017828), Testosterone (MESH:D013739), Anisomycin (MESH:D000841), Carbamazepine (MESH:D002220), 5-Fluorouracil (MESH:D005472), Dasatinib (MESH:D000069439), Enterolactone (MESH:C029497), steroid (MESH:D013256)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

9 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12515496/full.md

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Source: https://tomesphere.com/paper/PMC12515496