ReviewFrontiers in immunology2026
Immune mechanisms in the pathogenesis of endometriosis: a comprehensive analysis of the role of NK cells, cytokines, and extracellular vesicles/exosomes.
Review in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Endometriosis is a chronic, estrogen-dependent inflammatory disorder affecting approximately 10% of women of reproductive age. Retrograde menstruation is widely accepted as a primary mechanism for ectopic endometrial seeding; however, only a subset of individuals develop the disease. This suggests additional pathogenic processes. Increasing evidence suggests impaired immune surveillance as a central factor enabling ectopic endometrial tissue to persist and expand. This review aims to explore immune-associated pathogenic mechanisms in endometriosis, focusing on the interplay between natural killer (NK) cells, cytokines, and extracellular vesicles (EVs). Methods: This study was conducted as a narrative review. Relevant PubMed studies addressing immune dysfunction in endometriosis were identified, with emphasis on the role of NK cells, cytokines, EVs, and EV-mediated signaling. All material chosen for referral in the review consists of published reports that were critically evaluated and discussed. Results: Endometriosis is associated with impaired immune surveillance, characterized by reduced NK-cell cytotoxicity, driven by altered receptor expression and a shift toward regulatory NK-cell subsets. A dysregulated cytokine milieu combines pro-inflammatory signals that promote lesion growth with immunosuppressive factors that inhibit immune clearance of ectopic tissue. Lesion-derived EVs further contribute the lesions' survival by suppressing cytotoxic immune function, inducing apoptosis of activated immune cells and promoting inflammation and angiogenesis. The referred results highlight key immunological mechanisms underlying endometriosis. Discussion: This review presents an immune-based model in which NK-cell dysfunction, cytokine imbalance, and EV-mediated signaling cooperate to establish an immune-privileged microenvironment that promotes the survival and growth of ectopic endometrial tissue. The immune escape mechanism, described here, highlights potential targets as candidates to be tested for immunomodulatory therapies. We conclude that endometriosis should be considered a disorder fundamentally linked to mechanisms of immune dysregulation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.