Single‐Cell Atlas of Human Ovaries Reveals The Role Of The Pyroptotic Macrophage in Ovarian Aging

Abstract Female fecundity declines in a nonlinear manner with age during the reproductive years, even as ovulatory cycles continue, which reduces female fertility, disrupts metabolic homeostasis, and eventually induces various chronic diseases. Despite this, the aging‐related cellular and molecular changes in human ovaries that occur during these reproductive years have not been elucidated. Here, single‐cell RNA sequencing (scRNA‐seq) of human ovaries is performed from different childbearing ages and reveals that the activation of the pyroptosis pathway increased with age, mainly in macrophages. The enrichment of pyroptotic macrophages leads to a switch from a tissue‐resident macrophage (TRM)‐involve immunoregulatory microenvironment in young ovaries to a pyroptotic monocyte‐derived macrophage (MDM)‐involved proinflammatory microenvironment in middle‐aged ovaries. This remolded ovarian immuno‐microenvironment further promotes stromal cell senescence and accelerated reproductive decline. This hypothesis is validated in a series of cell and animal experiments using GSDMD‐KO mice. In conclusion, the work expands the current understanding of the ovarian aging process by illustrating a pyroptotic macrophage‐involved immune mechanism, which has important implications for the development of novel strategies to delay senescence and promote reproductive health.