The double engines and single checkpoint theory of endometriosis

Che‐Fang Hsu, Aye Aye Khine, Hsuan-Shun Huang, Tang‐Yuan Chu
In: Authorea, Inc. · 2022 · doi:10.22541/au.164450638.85346134/v1 · W4211162943
preprint OA: gold CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This paper proposes a new theory of endometriosis development, highlighting the combined roles of menstruation and ovulation as "double engines" driving the disease, with a single immune "checkpoint" mechanism failing to prevent its progression.

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Abstract

Endometriosis is a common chronic disease of women characterized by ectopic localization of the endometrial tissue in the peritoneal cavity. The pathogenesis of endometriosis closely resembles that of gynecological cancers in ways of menstruation- and ovulation-driven, wide intraperitoneal seeding, somatic hypermutation, and immune escape. While retrograde menstruation is regarded as the primary cause of endometriosis, the role of ovulation in the development of endometriosis has long been overlooked. We present the double engines, one checkpoint theory of the evolution of endometriosis. This new theory may lead to new concepts and strategies for preventing and treating this disease.

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endometriosis

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europepmc
last seen: 2026-06-14T06:08:20.186862+00:00
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License: CC0 · commercial use OK