{"paper_id":"ea7e413f-a6d0-419a-9cb6-c17a7fee38ee","body_text":"%PDF-1.4\n%����\n1 0 obj\n<< /Lang (en-US) /Metadata 3 0 R /Names 4 0 R /OpenAction [ null /Fit ] /Outlines 5 0 R /PageLabels 6 0 R /PageMode /UseOutlines /Pages 7 0 R /StructTreeRoot 8 0 R /Threads 9 0 R /Type /Catalog /ViewerPreferences << /DisplayDocTitle true >> >>\nendobj\n2 0 obj\n<< /Author (Ulrika Ottander) /CreationDate (D:20260802131612+08'00') /Keywords (endometriosis; immune surveillance; NK cells; NKG2D; MICA/B; FasL; cytokines; EVs/exosomes) /ModDate (D:20260802131619+08'00') /Subject (Ottander U, Bj�rk E, Israelsson P and Mincheva-Nilsson L \\(2026\\) Immune mechanisms in the pathogenesis of endometriosis: a comprehensive analysis of the role of NK cells, cytokines, and extracellular vesicles/exosomes. Front. Immunol. 17:1885409. doi: 10.3389/fimmu.2026.1885409) /Title (Immune mechanisms in the pathogenesis of endometriosis: a comprehensive analysis of the role of NK cells, cytokines, and extracellular vesicles/exosomes) >>\nendobj\n3 0 obj\n<< /Subtype /XML /Type /Metadata /Length 3394 >>\nstream\napplication/pdf\nUlrika Ottander\nEmma Björk\nPernilla Israelsson\nLucia Mincheva-Nilsson\nOttander U, Björk E, Israelsson P and Mincheva-Nilsson L (2026) Immune mechanisms in the pathogenesis of endometriosis: a comprehensive analysis of the role of NK cells, cytokines, and extracellular vesicles/exosomes. Front. Immunol. 17:1885409. doi: 10.3389/fimmu.2026.1885409\nCopyright © 2026 Ottander, Björk, Israelsson and Mincheva-Nilsson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.\nendometriosis\nimmune surveillance\nNK cells\nNKG2D\nMICA/B\nFasL\ncytokines\nEVs/exosomes\nImmune mechanisms in the pathogenesis of endometriosis: a comprehensive analysis of the role of NK cells, cytokines, and extracellular vesicles/exosomes\nendometriosis; immune surveillance; NK cells; NKG2D; MICA/B; FasL; cytokines; EVs/exosomes\n2026-08-02T13:16:12+08:00\n2026-08-02T13:16:19+08:00\n2026-08-02T13:16:19+08:00\nTrue\nhttps://www.frontiersin.org/legal/copyright-statement\nuuid:22f3f701-2421-47fc-b37d-d275b1e2c7bc\nuuid:f64d3e46-7e4c-4527-a2d9-ade52cccb121\nendstream\nendobj\n4 0 obj\n<< /Dests 10 0 R >>\nendobj\n5 0 obj\n<< /Count 1 /First 11 0 R /Last 11 0 R >>\nendobj\n6 0 obj\n<< /Nums [ 0 12 0 R ] >>\nendobj\n7 0 obj\n<< /Count 18 /Kids [ 13 0 R 14 0 R ] /Type /Pages >>\nendobj\n8 0 obj\n<< /K [ 15 0 R 16 0 R ] /ParentTree 17 0 R /ParentTreeNextKey 1 /Type /StructTreeRoot >>\nendobj\n9 0 obj\n[ 18 0 R ]\nendobj\n10 0 obj\n<< /Kids [ 19 0 R 20 0 R 21 0 R 22 0 R ] >>\nendobj\n11 0 obj\n<< /Count -13 /Dest /First 23 0 R /Last 24 0 R /Parent 5 0 R /Title >>\nendobj\n12 0 obj\n<< /S /D >>\nendobj\n13 0 obj\n<< /Count 10 /Kids [ 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R ] /Parent 7 0 R /Type /Pages >>\nendobj\n14 0 obj\n<< /Count 8 /Kids [ 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R ] /Parent 7 0 R /Type /Pages >>\nendobj\n15 0 obj\n<< /A 43 0 R /Alt (Diagram illustrating the immunological interactions in endometriotic lesions, showing cytokine-induced inflammation, immune cell apoptosis, immune suppressive exosomes, NK cell functional impairment, and overall immune suppression and immune privilege within endometriosis pathophysiology.) /K 0 /P 8 0 R /Pg 36 0 R /S /Figure /T () >>\nendobj\n16 0 obj\n<< /A 44 0 R /Alt (Illustration titled \\215The landscape of endometriosis\\216 featuring two mountain shapes representing the processes of local inflammation and immune escape, with immune suppression described in the valley. Four text boxes explain key aspects: inflammatory response \\(driven by cytokines, exosomal miRNA, and lncRNA\\), survival and protection of endometriotic lesions \\(via immunosuppressive factors\\), failure to clear endometrial tissue \\(due to impaired receptor and immune function\\), and clinical implications \\(dysmenorrhea, chronic pelvic pain, infertility, and potential malignant transformation\\).) /K 1 /P 8 0 R /Pg 36 0 R /S /Figure /T () >>\nendobj\n17 0 obj\n<< /Nums [ 0 45 0 R ] >>\nendobj\n18 0 obj\n<< /F 46 0 R /I << /Title >> >>\nendobj\n19 0 obj\n<< /Limits [ ] /Names [ 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R 81 0 R 82 0 R 83 0 R 84 0 R 85 0 R 86 0 R 87 0 R 88 0 R 89 0 R 90 0 R 91 0 R 92 0 R 93 0 R 94 0 R 95 0 R 96 0 R 97 0 R 98 0 R 99 0 R 100 0 R 101 0 R 102 0 R 103 0 R 104 0 R 105 0 R 106 0 R 107 0 R 108 0 R 109 0 R 110 0 R ] >>\nendobj\n20 0 obj\n<< /Limits [ ] /Names [ 111 0 R 112 0 R 113 0 R 114 0 R 115 0 R 116 0 R 117 0 R 118 0 R 119 0 R 120 0 R 121 0 R 122 0 R 123 0 R 124 0 R 125 0 R 126 0 R 127 0 R 128 0 R 129 0 R 130 0 R 131 0 R 132 0 R 133 0 R 134 0 R 135 0 R 136 0 R 137 0 R 138 0 R 139 0 R 140 0 R 141 0 R 142 0 R 143 0 R 144 0 R 145 0 R 146 0 R 147 0 R 148 0 R 149 0 R 150 0 R 151 0 R 152 0 R 153 0 R 154 0 R 155 0 R 156 0 R 157 0 R 158 0 R 159 0 R 160 0 R 161 0 R 162 0 R 163 0 R 164 0 R 165 0 R 166 0 R 167 0 R 168 0 R 169 0 R 170 0 R 171 0 R 172 0 R 173 0 R 174 0 R ] >>\nendobj\n21 0 obj\n<< /Limits [ ] /Names [ 175 0 R 176 0 R 177 0 R 178 0 R 179 0 R 180 0 R 181 0 R 182 0 R 183 0 R 184 0 R 185 0 R 186 0 R 187 0 R 188 0 R 189 0 R 190 0 R 191 0 R 192 0 R 193 0 R 194 0 R 195 0 R 196 0 R 197 0 R 198 0 R 199 0 R 200 0 R 201 0 R 202 0 R 203 0 R 204 0 R 205 0 R 206 0 R 207 0 R 208 0 R 209 0 R 210 0 R 211 0 R 212 0 R 213 0 R 214 0 R 215 0 R 216 0 R 217 0 R 218 0 R 219 0 R 220 0 R 221 0 R 222 0 R 223 0 R 224 0 R 225 0 R 226 0 R 227 0 R 228 0 R 229 0 R 230 0 R 231 0 R 232 0 R 233 0 R 234 0 R 235 0 R 236 0 R 237 0 R 238 0 R ] >>\nendobj\n22 0 obj\n<< /Limits [ ] /Names [ 239 0 R 240 0 R 241 0 R 242 0 R 243 0 R 244 0 R 245 0 R 246 0 R 247 0 R 248 0 R 249 0 R 250 0 R 251 0 R 252 0 R 253 0 R 254 0 R 255 0 R 256 0 R 257 0 R 258 0 R 259 0 R 260 0 R 261 0 R 262 0 R 263 0 R 264 0 R 265 0 R 266 0 R 267 0 R 268 0 R 269 0 R 270 0 R 271 0 R 272 0 R 273 0 R 274 0 R 275 0 R 276 0 R 277 0 R 278 0 R 279 0 R 280 0 R 281 0 R 282 0 R 283 0 R 284 0 R 285 0 R 286 0 R 287 0 R 288 0 R ] >>\nendobj\n23 0 obj\n<< /Dest","source_license":"CC0","license_restricted":false}