A promising future for endometriosis diagnosis and therapy: extracellular vesicles - a systematic review

Simon M Scheck, Simon Scheck, Emily Sarah Jane Paterson, Emily S J Paterson, Claire E Henry, Claire Henry
Reproductive biology and endocrinology : RB&E · 2022 · vol. 20(1) , pp. 174 · doi:10.1186/s12958-022-01040-y · PMID:36544197 · PMC9768904 · W4312129702
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review explores extracellular vesicles' role in endometriosis, finding they contribute to disease development and hold diagnostic and therapeutic potential, though methodology requires standardization for clinical utility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review investigated how extracellular vesicles (EVs) and exosomes from endometrium or endometriosis lesions could contribute to endometriosis pathophysiology and to diagnostic and therapeutic opportunities, using searches across five databases for EV-related studies in subjects with endometriosis (human and animal; 28 studies included). The review reports that endometrium-derived EVs may contribute to disease development, while EVs from lesions are implicated in angiogenesis, immunomodulation, and fibrosis, and that EVs can be detected in blood with early data supporting diagnostic and recurrence detection. A major limitation is that EV isolation and characterization methods varied widely, only eight of 28 studies fully met EV characterization standards, and reporting of endometriosis type and patient populations was limited, making comparisons difficult. This paper is centrally about endometriosis — it systematically reviews extracellular vesicles for diagnosis, recurrence detection, and proposed mechanisms in endometriosis.

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Abstract

Endometriosis is a chronic, inflammatory gynaecological disease that can have severe negative impacts on quality of life and fertility, placing burden on patients and the healthcare system. Due to the heterogeneous nature of endometriosis, and the lack of correlation between symptom and surgical disease severity, diagnosis and treatment remain a significant clinical challenge. Extracellular vesicles (EVs) are biologically active particles containing molecular cargo involved in intercellular communication, that can be exploited for diagnostic and therapeutic purposes.We systematically reviewed studies exploring EVs and their role in endometriosis, specifically addressing diagnostic and therapeutic potential and current understanding of pathophysiology. Five databases (Pubmed, Embase, Medline, Web of Science, Google Scholar) were searched for keywords 'endometriosis' and either 'extracellular vesicles' or 'exosomes'.There were 28 studies included in the review. Endometrium derived EVs contribute to the development of endometriosis. EVs derived from endometriosis lesions contribute to angiogenesis, immunomodulation and fibrosis. Such EVs can be detected in blood, with early data demonstrating utility in diagnosis and recurrence detection. EV isolation techniques varied between studies and only eight of twenty-eight studies fully characterised EVs according to current recommended standards. Reporting/type of endometriosis was limited across studies. Varied patient population, type of sample and isolation techniques created bias and difficulty in comparing studies.EVs hold promise for improving care for symptomatic patients who have never had surgery, as well as those with recurrent symptoms after previous surgery. We encourage further EV research in endometriosis with the inclusion of rigorous reporting of both the patient population and technical methodology used, with the ultimate goal of achieving clinical utility for diagnosis, prognosis and eventually treatment.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Exosomes Exosomes Exosomes Exosomes Exosomes Exosomes Exosomes Extracellular Vesicles Extracellular Vesicles Extracellular Vesicles

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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