Comprehensive single-cell transcriptome analysis of autologous platelet-rich plasma therapy on human thin endometrium

Therapeutics for thin endometrium (TE) have emerged, with autologous platelet-rich plasma (PRP) therapy gaining significant attention. In the present study, ten eligible TE patients were recruited for PRP infusion. Endometrial tissue biopsies collected before and after PRP therapy (paired samples) were subjected to single-cell RNA sequencing (scRNA-seq). Additionally, haematoxylin and eosin (HE) and immunohistochemistry (IHC) were employed to validate changes in protein markers. The results demonstrated PRP therapy increased the average endometrial thickness in these patients. Cellular trajectory reconstruction analysis using gene counts and expression (CytoTRACE) scores indicated that high-stemness cells were more enriched in proliferating stromal cells (pStr) or stromal cells (Str) in post-PRP samples, while greater stemness was observed in glandular epithelial cells (GE) and luminal epithelial cells (LE). Gene set variation analysis (GSVA) revealed significant differences in mesenchymal‒epithelial transition (MET)-related gene signature scores between paired samples. Furthermore, an increased number of macrophages, particularly M1-type macrophages, was detected in post-PRP samples. As the first study to investigate the effects of PRP therapy via transcriptomic analysis, our findings suggest PRP therapy may enhance high-stemness, stimulate MET, and boost macrophage function. These insights contribute to a better understanding of the mechanisms underlying PRP therapy and its potential in treating TE patients.