Pernicious placenta previa with placenta percreta (PP) is a catastrophic condition during pregnancy. However, the underlying pathogenesis remains unclear. In the present study, the placental tissues of normal cases and PP tissues of pernicious placenta previa cases were collected to determine the expression profile of protein‐coding genes, miRNAs, and lncRNAs through sequencing. Weighted gene co‐expression network analysis (WGCNA), accompanied by miRNA target prediction and correlation analysis, were employed to select potential hub protein‐coding genes and lncRNAs. The expression levels of selected protein‐coding genes, Wnt5A and MAPK13, were determined by quantitative PCR and immunohistochemical staining, and lncRNA PTCHD1‐AS and PAPPA‐AS1 expression levels were determined by quantitative PCR and fluorescence in situ hybridization. The results indicated that 790 protein‐coding genes, 382 miRNAs, and 541 lncRNAs were dysregulated in PP tissues, compared with normal tissues. WGCNA identified coding genes in the module (ME) black and ME turquoise modules that may be involved in the pathogenesis of PP. The selected potential hub protein‐coding genes, Wnt5A and MAPK13, were down‐regulated in PP tissues, and their expression levels were positively correlated with the expression levels of PTCHD1‐AS and PAPPA‐AS1. Further analysis demonstrated that PTCHD1‐AS and PAPPA‐AS1 regulated Wnt5A and MAPK13 expression by interacting with specific miRNAs. Collectively, our results provided multi‐omics data to better understand the pathogenesis of PP and help identify predictive biomarkers and therapeutic targets for PP.

中文翻译：

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综合分析为渗透性胎盘的发病机制提供多组学证据

恶性前置胎盘伴穿透性胎盘 (PP) 是怀孕期间的灾难性病症。然而，潜在的发病机制仍不清楚。在本研究中，收集了正常病例的胎盘组织和有害前置胎盘病例的 PP 组织，通过测序确定蛋白质编码基因、miRNA 和 lncRNA 的表达谱。加权基因共表达网络分析（WGCNA），伴随着miRNA靶点预测和相关性分析，被用来选择潜在的中枢蛋白编码基因和lncRNA。通过定量 PCR 和免疫组织化学染色以及 lncRNA PTCHD1-AS和PAPPA-AS1确定选定的蛋白质编码基因Wnt5A和MAPK13的表达水平通过定量PCR和荧​​光原位杂交确定表达水平。结果表明，与正常组织相比，PP组织中有790个蛋白质编码基因、382个miRNA和541个lncRNA失调。WGCNA 在模块 (ME) black 和 ME turquoise 模块中鉴定了可能参与 PP 发病机制的编码基因。选择的潜在中枢蛋白编码基因Wnt5A和MAPK13在 PP 组织中下调，其表达水平与PTCHD1-AS和PAPPA-AS1的表达水平呈正相关。进一步分析表明，PTCHD1-AS和PAPPA-AS1通过与特定 miRNA 相互作用来调节 Wnt5A 和 MAPK13 的表达。总的来说，我们的结果提供了多组学数据，以更好地了解 PP 的发病机制，并帮助确定 PP 的预测性生物标志物和治疗靶点。