For most women past pubescence, the uterine lining, or the endometrium, sheds itself from the body roughly every month if there is no fertilized egg present. Then, the uterus rebuilds itself to prepare for a potential pregnancy. While this process, called the menstrual cycle, is widely known, how it works is not well understood.
Researchers from the University of Missouri School of Medicine are one step closer to unlocking how the uterus repairs itself and if the process could be used in future medical treatments. They studied mesenchymal-epithelial transition (MET), a process where certain cells transition from a flexible, migratory state into stationary, structural cells that line the endometrium. The team investigated how MET helps restore the uterine lining after events like menstruation or pregnancy.
“The uterus is like an open wound after childbirth or menstruation,” study author Amanda Patterson said. “So, it needs to heal itself very quickly. MET is just one of many mechanisms that help repair the lining. According to our research, the cells from MET act like a bandage on the open areas and are later replaced by native uterine cells.”
Although it’s unclear why the MET cells are replaced, it could explain why certain diseases involving the endometrium develop, like endometriosis or endometrial cancer. If something goes wrong with the cellular transition process, it could leave the uterus open to infection or allow abnormal cell growth outside of the uterus.
“An embryo can’t implant in an open uterus, so this could cause some potential issues with fertility,” Patterson said. “Dysregulated repair can lead to inflammation, lesions or even pockets of cancer, which can be painful and even debilitating.”
Patterson and her co-researchers identified signaling pathways used during MET in the uterus, which potential therapies and treatments could target. There are still many unanswered questions that the team plans to address.
“The uterus is a really incredible organ that undergoes extreme repair events regularly,” Patterson said. “It does it very efficiently and we need to understand how and why MET happens and how it can go awry in various diseases so we can help people with these conditions.”
Amanda Patterson, PhD is an associate professor of Reproductive Biology in Obstetrics, Gynecology and Women's Health, and a NextGen Precision Health investigator.
“Mesenchymal-epithelial transition supports rapid repair of the endometrial epithelium during postpartum uterine regeneration” was recently published in Communications Biology, a journal published by Nature. In addition to Patterson, Mizzou study authors include Zidao Wang, former postdoc; Jonathas Medeiros de Almeida, lab technician; and Susanta Bahura, PhD, assistant professor in the Division of Animal Sciences. Kimberly Davenport from Washington State University contributed.
Communications Biology
Experimental study
Animals
Mesenchymal-epithelial transition supports rapid repair of the endometrial epithelium during postpartum uterine regeneration
11-May-2026
The authors declare no competing interests.