Exploring Autophagy-Associated Genes in the Endometrium of Recurrent Spontaneous Abortion and Examining their Relationship with Immune Infiltration

Abstract Recurrent spontaneous abortion (RSA) is a common complication in pregnant women. Autophagy impacts the initiation and progression of various diseases,the specific role of autophagy in the process of endometrial decidualization in RSA paitents is still largely unknown. The purpose of this research was to examine the involvement of autophagy-related genes (ARGs) in decidualization associated with RSA using bioinformatics approaches.To identify differentially expressed genes (DEGs), the Gene Expression Omnibus database provided gene expression datasets GSE165004 and GSE26787. ARGs were retrieved from the Human Autophagy Database and the Human Autophagy Modulator Database, and their intersection with DEGs resulted in 109 differentially expressed ARGs which were significantly enriched in 14 GO terms and and 10 KEGG pathways. To assess the diagnostic capacity of the genes, an receiver operating characteristic curve was utilized. Simultaneously,The disparities in RSA immune microenvironments between low- and high- expression gene groups were analyzed using CIBERSORT, indicating that AKT2, BCL2L1, CTNNB1, GRB2, GSK3B, PTEN, and PTPN11 may be linked to the immune response during decidualization within the endometrial microenvironment. Among them, hub genes exhibited positive correlations with neutrophils, mast cells, and dendritic cells, and negative correlations with plasma, memory B and naive B cells. The results show that the 10 DEARGs (AKT2, RPS27A, PTPN11, PIK3CD, PTEN, CTNNB1, KRAS, GSK3B, BCL2L1, and GRB2) could act as potential biomarkers for the diagnosis of RSA. Furthermore, a noteworthy correlation was detected between DEARGs and the immune landscape of the endometrium in RSA patients.