This review article gives an overview of the aetiology of endometriosis and sheds light on the role of immunological factors in the development ofendometriosis. Although retrograde menstruation is a common phenomenon among women of reproductive age, not all women who have retrograde menstruation develop endometriosis. The development of endometriosis is hypothesised to be a complex process, towards which multiple factors might be contributing at the same time, including the quantity and quality of endometrial cells in peritoneal fluid (PF), increased inflammatory activity in PF, increased endometrial-peritoneal adhesion and angiogenesis, reduced immune surveillance and clearance of endometrial cells, and increased production of autoantibodies against endometrial cells. Cytokines and autoantibodies upregulated during development of endometriosis may be used as markers for early diagnosis of endometriosis. Though hormone suppression is the treatment of choice for endometriosis, there is need for non-hormonal drugs, which can inhibit the development of endometriosis and alleviate pain or infertility without inhibition of ovulation. New molecules that modulate immune function should be explored for the treatment of endometriosis.
Endometriosis, immune mechanisms