# Role of senescent cells in uterine fibroid pathogenesis

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $803,402

## Abstract

Uterine fibroids affect 70-80% of US women, leading to heavy menstrual bleeding, pelvic pain, and infertility. A
prominent feature of uterine fibroids is the presence of a structurally dysregulated and fibrotic extracellular matrix.
Despite their prevalence and the immense public health burden they cause, non-surgical treatment options are
limited.
 Research from many groups has revealed a role of senescent cells in dysfunctional fibrosis, such as
idiopathic pulmonary fibrosis and foreign body fibrosis. In previous research we demonstrated that senescent
cells secrete soluble factors that modulate immune cells, resulting in a feed-forward loop that reinforces a Type
3 immune response and cellular senescence in a fibrosis model of the foreign body reaction.
 In this project we have used cutting-edge single cell RNA sequencing and new computational methods
to study senescent and immune cells in uterine fibroids. We observed that extensive numbers of senescent cells
were present in human fibroids compared to adjacent uterine tissues which had few, or no, senescent cells.
Immunofluorescence staining revealed p16+ cells with a fibroblastic morphology were present in all fibroid
tissues evaluated. Furthermore, the senescent cells were associated with macrophages and abnormal
vascularity in the fibroids compared to normal tissues. Multi-spectral flow cytometric analysis confirmed changes
in macrophage phenotype and increased numbers of T cells in the fibroids, compared to normal myometrium.
Notably, preliminary single cell RNA Sequencing (scRNASeq) analysis of fibroid and normal myometrium
revealed multiple cell types that exhibited senescent phenotypes, paving the way for further mechanistic analysis
of immune-stromal communication associated with fibrosis. Finally, senescent cell numbers in fibroids decreased
significantly after fibroids were injected with collagenase in a phase 1 clinical trial, in support of senescent cells
as a viable therapeutic target for treatment of fibroids. This research will test the overarching hypothesis that
senescent – immune cell interactions regulate and contribute to abnormal vascularity and fibrosis in fibroid
development and pathogenesis. We will pursue three specific aims.
 Aim 1 seeks to characterize the presence, phenotype, and function of senescent cells and their
interaction with immune cells in uterine leiomyoma. Experiments in Aim 2 will validate key senescent cell
interaction in fibroid development and determine the impact of environmental factors on senescent cells. Aim 3
will evaluate the effect of senolytic drugs on uterine leiomyomas, in vitro and in vivo.
 Elucidation of key relationships and cell drivers of the dysfunctional fibrosis in fibroids is likely to have a
broad impact on the field. Unraveling the cell-cell immune communication networks may explain how myometrial
tissues transform to develop into fibroids. Affirmation of the key role of senescent – immune cell interactions in
fibroid pathogene...

## Key facts

- **NIH application ID:** 10809637
- **Project number:** 5R01HD111243-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mostafa A. Borahay
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $803,402
- **Award type:** 5
- **Project period:** 2023-03-15 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10809637

## Citation

> US National Institutes of Health, RePORTER application 10809637, Role of senescent cells in uterine fibroid pathogenesis (5R01HD111243-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10809637. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
