Sequential Transcriptional Programs of Tissue Residency Drive Human Uterine NK Cell Development

Uterine natural killer cells are critical for pregnancy success, but the origin and development of these cells in humans remain unclear. Here we use various single cell approaches to identify the transcriptional programs governing uterine NK cell development in humans. These analyses suggest a developmental continuum which begins with seeding of the endometrium with blood immature CD56 ^bright precursors, evolves through CD56 ^bright endometrial founder NK cells, and ends with tissue resident decidual NK cells during pregnancy which possess non-cytotoxic functions. Our work identifies a role for sequential programs of tissue residency in the differentiation of these cells, as differentiating endometrial tissue resident NK (trNK) cells acquire early and late transcriptional programs of residency which coincide with acquisition of unique non-cytotoxic effector programs. Notably, we identified early residency programs in human endometrial trNKs by expression of NR4A2 , AP-1 transcription factors, and other immediate early response genes that were shared with CD8 tissue resident memory T cells in mice, suggesting conservation of transcriptional programs of early tissue residency programs across species and cell types. Late residency programs were guided by TGFβ, which promoted expression of various integrins and trNK subset diversification within the non-pregnant endometrium. Altogether, these data identify the molecular foundations for endometrial trNK heterogeneity and suggest that the uterine NK diversity observed during pregnancy is established before embryo implantation and intimately tied to residency programming.