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Study Objective To identify the expression of PIWI associated RNA (piRNA) in tissues of endometrium and endometrioid ovarian cysts and to evaluate differences in the expression of piRNA between eutopic and ectopic endometrium. Design Prospective observational cohort study; Level II-1. Setting Federal State Budget Institution «The National Medical Research Center for Obstetrics, Gynecology and Perinatology», Moscow. Patients or Participants The study included 21 patients of reproductive age (30.27 ± 3.78 years) with endometrioid ovarian cysts. Paired samples of endometrial tissues were collected during surgery in the proliferative phase of menstrual cycle. Tissue samples for further analysis were selected after histological examination. The analysis of piRNA expression was carried out by the new generation sequencing on the Illumina platform, followed by processing of the data by bioinformatics analysis. Interventions Laparoscopic surgery for endometriod ovarian cysts and endometrial biopsy followed by histopathologic and piRNA expression analysis of obtained tissue. Measurements and Main Results According to the sequencing data, 197 piRNA were identified in the tissues of the eutopic endometrium and endometrioid ovarian cysts. The analysis of differential expression revealed predominantly reduced expression of piRNA in the ectopic endometrium relative to the eutopic endometrium. In total 30 differentially expressed piRNA were identified, including 4 with increased and 26 with reduced expression. Using bioinformatic methods, possible gene targets of differentially expressed piRNA were found. Functional analysis of potential targets of differentially expressed piRNA revealed signaling pathways and cellular processes that may contribute to the development of endometriosis. Conclusion The data obtained suggest that alterations in piRNA expression of ectopic endometrium and subsequent disturbances in the expression of their target genes may be significant link in our search for the pathogenesis of endometriosis.

Study Objective Profiling of miRNA and mRNA in eutopic and ectopic endometrial tissues in patients with endometrioma. Design A prospective cohort study. Setting This study was conducted at the Department of Operative Gynecology of V.I. Kulakov National Medical Center for Obstetrics, Gynecology, and Perinatology. Patients or Participants This study included 136 women of reproductive age from 18 to 38 years with endometriomas (OE). Interventions Determination of the differences in the expression of miRNA and mRNA in the tissues of OE (EcE) and eutopic endometrium (EuE); bioinformatic analysis to evaluate the role of differentially expressed RNA in the pathogenesis of OE; analysis of microRNA transcriptome (TRA) performed by the sequencing method. Measurements and Main Results TRA revealed significant differences in the expression of miRNA and mRNA in EcE and EuE. It was found that the expression of miRNA and mRNA depends on the type of ovarian reserve (OVR). Lists of target genes were obtained for identified miRNAs were involvement of regulated target genes in the processes of proliferation, in migration and invasion, and in the key cascades of intracellular signaling and inflammatory processes and in the processes of DNA repair and regulation of the mitotic cycle, which indicates the genotoxic effect of pathogenetic factors acting in the tissues of OE and on adjacent ovarian tissues. Conclusion The data obtained suggest that the change in the expression of microRNA in the tissues of the ectopic endometrium can make a significant contribution to the development of endometriosis and the associated reduction of the OVR.