Immunotherapy: A promising novel endometriosis therapy

Abstract

Endometriosis is a common disease of the female reproductive system and has malignant features. Although endometriosis by itself is a benign disease, its erosive growth characteristics lead to severe pelvic pain and female infertility. Unfortunately, several aspects of the pathogenesis of endometriosis are still unclear. Furthermore, the clinical therapeutic methods are unsatisfactory. The recurrence rate of endometriosis is high. Accumulating evidence suggests that the onset and development of endometriosis are closely related to the abnormal function of the female autoimmune system, especially the function of some immune cells such as the aggregation of neutrophils, abnormal differentiation of macrophages, decreased cytotoxicity of NK cells, and abnormal function of T- and B-cell lines. Therefore, immunotherapy is probably a novel therapeutic strategy for endometriosis besides surgery and hormone therapy. However, information regarding the clinical application of immunotherapy in the treatment of endometriosis is very limited. This article aimed to review the effects of existing immunomodulators on the development of endometriosis, including immune cell regulators and immune factor regulators. These immunomodulators clinically or experimentally inhibit the pathogenesis and development of endometriosis lesions by acting on the immune cells, immune factors, or immune-related signaling pathways. Thus, immunotherapy is probably a novel and effective clinical treatment choice for endometriosis. Experimental studies of the detailed mechanism of immunotherapy and large-scale clinical studies about the effectiveness and safety of this promising therapeutic method are required in the future.

Unraveling immunotherapeutic targets for endometriosis: a transcriptomic and single-cell analysis

“…In this study, the distribution of most immune cells was dysregulated in EMs, which is consistent with the findings of previous studies ( 14 , 32 ). In particular, EMs was associated with decreased cytotoxicity of NK cells, an increased abundance and cytotoxicity of macrophages, aberrant activation of T cells and B cells, and enhanced density and number of mast cells and dendritic cells.…”

Immune pathway through endometriosis to ovarian cancer

“…Therefore, immune therapy holds promise as a potential treatment approach for this condition. The reduced macrophagic phagocytosis observed in the serum and peritoneal fluid of individuals with endometriosis is a significant contributor to the disruption of immune balance[ 262 ]. In this sense, the expression of CD47 is used by macrophages to distinguish “self” or “non-self” cells.…”

“…Furthermore, it has been reported that exosomes originating from endometriosis can induce a shift in macrophage phenotype toward M2 polarization, leading to a reduction in macrophage phagocytic activity both in laboratory settings ( in vitro ) and within the body ( in vivo )[ 262 ]. As a result, employing anti-exocrine therapy for individuals with endometriosis appears to have a notable effect on attracting macrophages to ectopic lesions[ 266 ].…”

Potential Significance of Serum Autoantibodies to Endometrial Antigens, α-Enolase and Hormones in Non-Invasive Diagnosis and Pathogenesis of Endometriosis

“…The study of autoantibodies to molecules that play an important role in the pathophysiology of endometriosis, in particular to specific endometrial antigens (TPM, TMOD), the glycolytic enzyme α-enolase 1 (ENO) involved in endometrial cell invasion, as well as to steroids (estradiol (E2), progesterone (PG)) and gonadotropins, in various forms of endometriosis, may contribute to a deeper understanding of the immune aspects of the pathophysiology of endometriosis, identifying promising diagnostic biomarkers and proposing new treatment strategies [23]. In connection with the above, the aim of this study was to evaluate the profile of serum autoantibodies and their diagnostic and pathogenetic significance in ovarian endometrioma and deep infiltrative endometriosis.…”