{"paper_id":"c322e226-fe27-4ead-b5e5-f2a98383edac","body_text":"Abstract\nMolecular and cellular features of ectopic endometriotic lesions differ from eutopic endometrium. Estrogen-mediated cell signaling is altered, and pro-inflammatory pathways develop in the local microenvironment along with impaired cellular immunity. A multitude of growth factors, cytokines, and angiogenic factors play a critical role. Refluxed endometrial cells eventually adhering, invading, and proliferating along with neovascularization result in progression to a disease state characterized by evasion of the immune surveillance system by ectopic endometrial tissue. This failure of natural clearance by the immune system and resistance to apoptosis by ectopic endometrial cells results in chronic progression of disease. There is increasing evidence for epigenetic mechanisms involved in the pathogenesis of endometriosis. 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Springer, Cham. https://doi.org/10.1007/978-3-030-52984-0_5\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-52984-0_5\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-52983-3\nOnline ISBN: 978-3-030-52984-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}