Endometrial cells with high ALDH activity contribute to uterine development and regeneration

  1. Suni Tang
  2. Anna Catherine Unser
  3. Peixin Jiang
  4. Sydney E Parks
  5. Genesis J Herrera
  6. Ting Geng
  7. Linda Alpuing Radilla
  8. Brooke A Thigpen
  9. Xiaoming Guan
  10. Diana Monsivais  Is a corresponding author
  1. Department of Pathology and Immunology, Baylor College of Medicine, United States
  2. Center for Drug Discovery, Baylor College of Medicine, United States
  3. Department of Obstetrics and Gynecology, Baylor College of Medicine, United States
9 figures and 6 additional files

Figures

Figure 1 with 1 supplement
Mouse endometrial epithelial ALDHHI cells have higher organoid formation capacity and stemness transcriptomes.

(A–C) Strategy to isolate and establish ALDHHI and ALDHLO cells from adult wild-type (WT) mouse epithelial organoids using the ALDEFLUOR assay. (D–E) Organoid formation assay performed immediately after luminal epithelial cell isolation by plating equal numbers of viable ALDHLO (D) and ALDHHI (E) epithelial cells. ALDHLO and ALDHHI organoids were cultured for 2 weeks and passaged once prior to the organoid formation assays and transcriptomic analyses. (F–H) Organoid formation rate (F), organoid perimeter (G), and area (H) were assessed by quantifying the total number of organoids formed per 100 cells seeded. Assays were performed using the cells pooled from seven to nine WT adult mice at estrus three independent times. (I–J) Transcriptomic profiling of ALDHHI vs. ALDHLO mouse organoids was performed, and the total number of differentially expressed genes (DEG) was determined (I). The total number of up- and down-regulated genes was displayed as a volcano plot. (J) Gene ontology analysis was performed on the up- and down-regulated genes between the ALDHLO vs. ALDHHI organoids. (K) Comparison of total genes that are conserved as up- or down-regulated between ALDHHI/AXIN2HI and ALDHLO/AXIN2LO cells, selected genes involved in stemness signatures are displayed. Graphs show mean ± SEM and were analyzed using a non-parametric Mann-Whitney Test, *, p<0.05; **, p<0.01; ***, p<0.001.

Figure 1—figure supplement 1
Analysis of differentially expressed gene (DEG) in ALDHHI vs. ALDHLO mouse organoids.

Clustering analysis of stemness-related (A) and keratin genes (C) in the mouse epithelial cells established from ALDHHI or ALDHLO organoids. (B) Overlap of ALDHHI genes that are increased and decreased with AXIN2HI endometrial epithelial stem cells in mouse.

Figure 2 with 2 supplements
ALDH1A1 is expressed in cells with epithelial stem cell (EpSC) characteristics.

(A–B) UMAP displaying the various cell types identified by scRNAseq of enriched endometrial epithelium from wild-type (WT) 6-week-old mice in the estrus (A) and diestrus (B) phases. Epithelial cells were sub-clustered to identity different cell identities (C) and classified into luminal, glandular, and EpSCs based on the expression of key markers (D, estrus; E, diestrus). (F–I) Pseudotime analysis of the epithelial cell types in estrus (F, G) and diestrus (H,I) was performed to identify the trajectory of differentiation, which shows that EpSCs give rise to glandular and epithelial cell lineages. (J–L) Dual feature plots showing the overlapping and unique expression patterns of Aldh1a1/Lgr5 (J), Aldh1a1/Axin2 (K), and Lgr5/Axin2 (L) in the epithelial cell clusters in estrus. (M–O) A signature score was assigned to the epithelial cells from the estrus phase to determine how strongly genes involved in ‘Glandular Epithelial Development’ (M), ‘BMP signaling’ (N), and ‘Stereocilium’ (O) are expressed. (P–S) ALDH1A1 immunohistochemistry in the uterus of adult WT mice during the diestrus (P-P’) and estrus (Q-Q’) phases, or in WT ovariectomized mice without (R-R’) or with an E2 pellet for 90 days (S-S’). (T) Aldh1a1 was also quantified in the uterus of 6- to 8-week-old WT mice collected at different times during the estrous cycle. Experiments were repeated in more than three mice per group. Data in T are displayed as mean ± SEM analyzed by a one-way ANOVA test with a Tukey’s post-hoc test. *, p<0.05; **, p<0.01; ***, p<0.001. UMAP, uniform manifold approximation and projection; BMP, bone morphogenetic protein.

Figure 2—figure supplement 1
Identification and characterization of epithelial stem cells (EpSCs) in the adult wild-type (WT) mouse uterus at estrus and diestrus.

(A) Dot plots showing the expression of Aldh1a1, Lgr5, and Axin2 across the epithelial cell subclusters from the estrus and diestrus phases. (B) Estrus and diestrus phase expression of genes identifying epithelial, luminal, and EpSC clusters across each cluster of epithelial cells. (C) Heatmap (row for gene, column for individual cell) comparing epithelial cell subclusters from our dataset to differentially expressed genes (DEGs) identified from EpSC DEGs of cluster 12 (Padilla-Banks et al., 2023). (D) Uniform manifold approximation and projection (UMAP) of epithelial cell subclusters from mouse samples obtained during the estrus (E) or diestrus phases (F). (F–L) Lineage trajectories using pseudotime analysis of the epithelial cell types in estrus (F,G) and diestrus (H–L).

Figure 2—figure supplement 2
Estrogen and progesterone impact the expression and localization of ALDH1A1 in the wild-type (WT) mouse uterus.

(A) Description of the experimental scheme used to ovariectomize and administer hormonal treatments to 6- to 8-week-old WT mice. (B-E’) ALDH1A1 immunohistochemistry in the uterine cross-sections of ovariectomized mice treated with vehicle (B-B’), 1 mg P4 (C-C’), 50 ng E2 (D-D’), or 1 mg P4+50 ng E2 (E-E’). (F) Aldh1a1 gene expression was quantified in the uterine tissues of the ovariectomized mice treated with vehicle, P4, E2, or E2+P4. Experiments were repeated in more than three mice per group. Data in F displayed as mean ± SEM analyzed by a one-way ANOVA test with a Tukey’s post-hoc test. *, p<0.05; **, p<0.01; ***, p<0.001.

Lineage tracing reveals the contribution of ALDH1A1+ cells to endometrial integrity.

(A-C’) ALDH1A1 immunohistochemistry in the wild-type (WT) mouse uterus at PND7 (A-A’), PND14 (B-B’), and 3 weeks (C-C’). (D) Schematic of the tamoxifen-inducible ALDH1A1 reporter allele and experimental scheme used for lineage tracing in the postnatal endometrium. (E-N’) Red fluorescent protein (RFP) immunohistochemistry was used to detect the ALDH1A1-tdTomato-expressing cells in the uterus when tracing was performed from PND7 to PND8 (E-E’), PND8 to PND14 (F-F’), PND8 to PND56 (G-G’), PND14 to PND15 (I-I’), PND14 to PND28 (J-J’), PND14 to PND56 (K-K’), or PND21 to PND22 (M-M’), or PND21 to PND56 (N-N’) with tamoxifen (0.15 mg/g body weight). (H, L, O) Quantification of RFP+ cells was performed and are presented as total RFP+ endometrial epithelial or stromal cells. Black arrows (E’, I’, M’) indicate singly labeled RFP+ cells; the red arrow (K’) indicates an RFP+ stromal cell. Images represent staining that was performed in three or more mice per timepoint. Data are presented as mean ± SEM analyzed by a two-way ANOVA with a Sidak test for multiple comparisons. *, p<0.05; **, p<0.01; ***, p<0.001. PND, postnatal day; TAM, tamoxifen; ORF, open-reading frame.

Tracing of ALDH1A1+ cells in the adult cycling uterus identified positive cells in the epithelium and stroma.

(A) Schematic diagram demonstrating the reabsorption and reorganization that occurs between estrous phases in the adult mouse uterus. Uterine structures are labeled as: M for mesometrial, AM for anti-mesometrial, Myo for myometrium, S for stromal compartment, and LE for luminal epithelium. (B) Timeline for tamoxifen (TAM)-dependent tomato labeling in ALDH1A1-expressing cells in the adult mice when traced for 1, 7, or 28 days after TAM administration. (C-E’) RFP immunohistochemistry was used to detect labeled cells when tracing was performed in the adult mouse for 1 day (C-C’), 7 days (D-D’), or 28 days (E-E’). Red arrows indicate detection of RFP in the subepithelial stromal cells. (F–G) Quantification of RFP+ cells in the epithelial and stromal compartments 1, 7, or 28 days after TAM administration. Data are presented as mean ± SEM analyzed by a two-way ANOVA with a Sidak test for multiple comparisons. *, p<0.05; **, p<0.01; ***, p<0.001.

Figure 5 with 1 supplement
ALDH1A1+ cells are detected in the postpartum regenerating endometrium.

(A) Schematic highlighting postpartum repair occurring at PPD1, PPD3, and PPD5. Uterine structures are labeled as: M for mesometrial, AM for anti-mesometrial, S for stromal compartment, LE for luminal epithelium, and GE for glandular epithelium. (B) ALDH1A1 lineage tracing was begun in the Aldh1a1creERT2;Rosa26LSL-tdTomato mice at 2 months of age. Two months after TAM administration, the mice were mated, and their uteri were collected at PPD1, PPD3, and PPD5. (C-E”) RFP immunohistochemistry shows the presence of ALDH1A1+ cells in areas near the placental detachment sites collected at PPD1 (C-C”), PPD3 (D-D”), and PPD5 (E-E”). Arrows indicate the RFP+ subepithelial stromal cells (C’-C”) and RFP+ stromal cells near the placental detachment sites (D’, E’). (F–J) Immunofluorescence staining of uterine cross-sections with cytokeratin 8 (CK8, cyan), red fluorescence protein (RFP, yellow), vimentin (VIM, magenta), and DAPI (white). Yellow arrowheads (F, G–J) show the presence of cells that are CK8+/RFP+/VIM+; white arrowheads indicate cells that are CK8+/VIM+. Images represent groups of more than three animals analyzed per group. (K) Analysis of the cells expressing CK8+/VIM+ in the uterine cross-sections at PPD3 and PPD5. Data are presented as mean ± SEM of positive cells per imaged field and analyzed by a Mann-Whitney test (M). *, p<0.0033; **, p<0.002; ***, p<0.001. TAM, tamoxifen; PPD, postpartum day.

Figure 5—figure supplement 1
ALDH1A1+ cells in the regenerating endometrium during the postpartum phase.

(A–F) RFP immunohistochemistry in the placental detachment sites of mice collected at postpartum day 1 (PPD1) (A-B’), PPD3 (C-D’), and PPD5 (E-F’). (G) Quantification of the RFP+ epithelial and stromal cells at PPD1, PPD3, and PPD5. Graph shows mean ± SEM.

Figure 6 with 2 supplements
Ablation of ALDH1A1+ cells impairs organoid expansion and reduces endometrial glands in adult mice.

(A–C) Diphtheria toxin (DT)-mediated ablation of ALDH1A1+ cells was obtained in vitro (A) and in vivo (B) by crossing Aldh1a1creERT2 mice to a line containing a conditional DT receptor allele (Rosa26LSL-DTR). (D–I) Organoids from adult control (Rosa26LSL-DTR) and experimental (Aldh1a1creERT2; Rosa26LSL-DTR) mice were established and expanded in culture for two passages. Once established (D–E), the organoids were treated with DT (F–G) and visualized, fixed, and stained with cleaved caspase-3 antibody (H–I). (J–K) The impact of DT-mediated ablation of ALDH1A1+ cells was determined in mice treated with TAM at PND7, and with DT at PND10. Uterine tissues were collected and analyzed at PND56 using immunohistochemistry to detect ALDH1A1 (J-K’). (L–M) Glands were visualized in the control mice (L) and experimental (M) by staining with FOXA2 (green), cytokeratin 8 (red), and DAPI (white) using confocal imaging. (N–O) FOXA2 intensity per gland (N) and glandular number (O) were quantified in the uterine cross-sections of >3 mice per genotype. The results are displayed as mean ± SEM and analyzed using a two-tailed t-test, *, p<0.05; **, p<0.01; ***, p<0.001.

Figure 6—figure supplement 1
Cleaved caspase 3 expression following diphtheria toxin (DT) administration in vivo.

(A-B’) Immunohistochemistry of the uterus of mice collected 4 days after DT administration in control, Rosa26LSL-DTR (A-A’) and Rosa26LSL-DTR;Aldh1a1creERT2/+ (B-B’) mice.

Figure 6—figure supplement 2
Genotyping strategy for the various mouse lines used in the study.

(A–E) Gel electrophoresis results and cycling conditions (B,D) showing the PCR results for the Aldh1a1creERT2/+ allele (A), for the Rosa26LSL-tdTomato Ai9 reporter (C), and for the diphtheria toxin receptor (DTR) knock-in and wild-type (WT) alleles (E).

Figure 6—figure supplement 2—source data 1

Uncropped gel blots for genotyping results.

https://cdn.elifesciences.org/articles/110975/elife-110975-fig6-figsupp2-data1-v1.zip
Figure 6—figure supplement 2—source data 2

Uncropped labeled DNA gels from genotyping results.

https://cdn.elifesciences.org/articles/110975/elife-110975-fig6-figsupp2-data2-v1.zip
Figure 7 with 2 supplements
ALDHHI cells from eutopic endometrium display organoid formation capacity and different transcriptomic signatures than ALDHLO cells.

(A) Schematic approach to isolate ALDHHI and ALDHLO cells from human endometrial epithelial organoids with the ALDEFLUOR assay. (B–C) Organoid establishment was assessed in freshly isolated ALDHLO and ALDHHI epithelial cells plated at equal densities. (D–F) Organoid formation assay was performed by plating equal numbers of viable ALDHLO (D) and ALDHHI (E) cells followed by quantifying the total number of organoids that were established per 100 cells plated (F). Graph displays the mean ± SEM of organoids from one patient in technical replicates and analyzed using a two-tailed t-test, *, p<0.05; **, p<0.01; ***, p<0.001. (G–J) Images comparing the growth of ALDHLO (G,I) and ALDHHI (H,J) organoids at passage 11 (G–H) or passage 16 (I,J) from one patient. (K) Volcano plot showing the total number of differentially expressed transcripts in the ALDHHI vs ALDHLO eutopic organoids from three different patients. (L–M) Gene enrichment analysis of increased (L) and decreased (M) genes in ALDHHI eutopic vs ALDHLO eutopic organoids. (N) Immunostaining of eutopic ALDHLO and ALDHHI organoids stained with cytokeratin 8 (CK8, green), acetylated-α-tubulin (AcTub, red), and DAPI (white).

Figure 7—figure supplement 1
Comparison of ALDHHI and ALDHLO formation in the organoids from human eutopic endometrial epithelium.

(A–B) Phase contrast images and quantification of an organoid formation assay comparing ALDHHI and ALDHLO cells. Data in C are displayed as mean ± SD analyzed by a two-tailed t-test. *, p<0.05; **, p<0.01; ***, p<0.001. Data are from one patient performed in technical replicates.

Figure 7—figure supplement 2
Gene expression pathways are differentially regulated between ALDHHI and ALDHLO cells in the eutopic endometrial organoids.

Clustering of the top 100 differentially expressed genes in ALDHHI vs ALDHLO human eutopic endometrial epithelial organoids.

Author response image 1
Purity of mouse endometrial epithelial cells obtained via enzymatic and mechanical dissociation.

(A-B) Shows the epithelial (A) and stromal (B) cells plated on glass coverslips and immunostained with an epithelial cell marker (cytokeratin 8, red), a stromal cell marker (vimentin, green), and DAPI.

Author response image 2
Human endometrial epithelial organoids were fixed and immunostained with cytokeratin 8 (green) and DAPI.

The images are typical for our epithelial cell cultures and demonstrate that all epithelial cells are CK8-positive.

Additional files

Supplementary file 1

Differentially expressed genes and gene enrichment analysis of ALDHHI vs. ALDHLO mouse endometrial epithelial organoids.

https://cdn.elifesciences.org/articles/110975/elife-110975-supp1-v1.xlsx
Supplementary file 2

Differentially expressed genes between clusters 4 and 25 versus other epithelial cell clusters in the scRNAseq dataset.

https://cdn.elifesciences.org/articles/110975/elife-110975-supp2-v1.xlsx
Supplementary file 3

Differentially expressed genes and gene enrichment analysis of ALDHHI vs. ALDHLO human endometrial epithelial organoids.

https://cdn.elifesciences.org/articles/110975/elife-110975-supp3-v1.xlsx
Supplementary file 4

Primer sequences and antibody information.

https://cdn.elifesciences.org/articles/110975/elife-110975-supp4-v1.docx
Supplementary file 5

Patient sample information.

https://cdn.elifesciences.org/articles/110975/elife-110975-supp5-v1.xlsx
MDAR checklist
https://cdn.elifesciences.org/articles/110975/elife-110975-mdarchecklist1-v1.docx

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  1. Suni Tang
  2. Anna Catherine Unser
  3. Peixin Jiang
  4. Sydney E Parks
  5. Genesis J Herrera
  6. Ting Geng
  7. Linda Alpuing Radilla
  8. Brooke A Thigpen
  9. Xiaoming Guan
  10. Diana Monsivais
(2026)
Endometrial cells with high ALDH activity contribute to uterine development and regeneration
eLife 15:RP110975.
https://doi.org/10.7554/eLife.110975.3