{"paper_id":"3fb49c0c-7894-4710-91b2-24ad9901bb94","body_text":"Endometriosis: current perspectives on etiology, pathogenesis, and molecular mechanisms of disease development (literature review)\nDOI:\nhttps://doi.org/10.15574/PP.2025.4(104).8289Keywords:\nendometriosis, pathogenesis, retrograde menstruation, metaplastic, immunological, genetic, hormonal, inflammatory, epigeneticAbstract\nEndometriosis (EM) is a multifactorial, estrogen-dependent chronic inflammatory disease characterized by the growth of endometrium-like cells outside the uterine cavity.\nAim - to summarize the main hypotheses of EM development based on current literature.\nA narrative review of PubMed, Scopus, Web of Science, and Google Scholar publications (2000-2025) was conducted. Included were original studies, systematic reviews, meta-analyses, and international guidelines on EM pathogenesis. Excluded were duplicates, low-evidence studies, and off-topic publications. Literature was categorized by theories: retrograde menstruation, metaplastic, immunological, genetic, hormonal, inflammatory, and epigenetic. Current concepts - the immunological, inflammatory, genetic, and epigenetic theories - explain mechanisms of EM survival, growth, angiogenesis, and progression. The hormonal theory emphasizes hyperestrogenism (elevated estrogen) and relative progesterone resistance. The genetic theory highlights hereditary predisposition and mutations in ESR1 and ESR2 (estrogen receptors), VEGF (vascular endothelial growth factor), KRAS and WNT4 (regulation of cell growth and invasion), and HLA-G (immune tolerance). Immunological dysfunction supports survival of ectopic lesions through impaired macrophage and regulatory T-cell activity. The most promising approach is an integrative model combining retrograde cell transport, immune dysfunction, hormonal imbalance, genetic susceptibility, and epigenetic modifications.\nConclusions. EM is a polyetiologic disease. 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J Hematol Oncol. 14(1): 1-13.\nDownloads\nPublished\nIssue\nSection\nLicense\nCopyright (c) 2025 Ukrainian Journal of Perinatology and Pediatrics\nThis work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.\nThe policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).\nAuthors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. 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