A mechanometabolic founder fragment model for endometriosis initiation

Aida Nonn
2026 · doi:10.5281/zenodo.20929302 · W7166111150
preprint OA: green CC0
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-19 ⓘ

This perspective proposes that endometriosis initiation relies on the selection of intact epithelial-stromal fragments from retrograde menstruation, with cervical impedance and fallopian tube transit potentially influencing fragment survival and delivery.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-16 · read from full text ⓘ

This perspective proposes a mechanometabolic model suggesting that endometriosis initiation relies on the selection of rare, intact epithelial-stromal fragments from refluxed menstrual tissue. The authors hypothesize that cervical impedance and fallopian tube transit act as filters, favoring fragments with preserved architecture and survival competence for retrograde delivery into the peritoneal cavity. A key translational prediction involves detecting a disease-associated shift in the mechanical survival fraction of these fragments under standardized shear challenges compared to controls. This paper is centrally about endometriosis — specifically focusing on the theoretical mechanisms underlying the initiation of lesions via retrograde menstruation and fragment selection.

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Abstract

Retrograde menstruation is common, whereas endometriosis is rare. This Perspective proposes a model in which initiation may depend on the selection of rare intact epithelial–stromal foundercandidate fragments from refluxed tissue. Cervical impedance and dysperistalsis may favour focal fragment generation and retrograde delivery, whereas fallopian-tube transit may select fragments with preserved architecture, survival competence and stromal permissiveness. The model generates testable predictions for menstrual-effluent profiling, peristalsis imaging and stretch priming, and its central translational prediction is a disease-associated shift, relative to controls, in the architecture-preserved mechanical survival fraction of menstrual-effluent fragments under a standardised confinement-and-pulsatile-shear challenge, after adjustment for total menstrual volume.
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A mechanometabolic founder fragment model for endometriosis initiation Description Retrograde menstruation is common, whereas endometriosis is rare. This Perspective proposes a model in which initiation may depend on the selection of rare intact epithelial–stromal foundercandidate fragments from refluxed tissue. Cervical impedance and dysperistalsis may favour focal fragment generation and retrograde delivery, whereas fallopian-tube transit may select fragments with preserved architecture, survival competence and stromal permissiveness. The model generates testable predictions for menstrual-effluent profiling, peristalsis imaging and stretch priming, and its central translational prediction is a disease-associated shift, relative to controls, in the architecture-preserved mechanical survival fraction of menstrual-effluent fragments under a standardised confinement-and-pulsatile-shear challenge, after adjustment for total menstrual volume. Files Nonn_2026_founder_fragment_preprint_v1_1.pdf Files (10.7 MB) | Name | Size | Download all | |---|---|---| | md5:2df59eb04c25427896337d0a3d18247a | 10.7 MB | Preview Download | | md5:545d3fc08e072d20c74287363c7c72e4 | 68.3 kB | Preview Download |

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