Endometriosis, Innate Immunity, and Soluble Decoy Receptors: A Translational Framework for Biomarker Discovery and Therapeutic Development

Endometriosis is a chronic inflammatory disease characterized by endometrial-like tissue growing outside the uterus. Increasing evidence suggests that innate immune pathways contribute to disease initiation, progression, and symptom development. Pattern-recognition receptors, including Toll-like receptors (TLRs), as well as their soluble counterparts (sTLRs), pathogen-associated molecular patterns (PAMPs), damage-associated molecular patterns (DAMPs), and related soluble decoy receptors may influence inflammatory signaling within the peritoneal environment. Although numerous studies have examined individual biomarkers, no comprehensive narrative synthesis has critically evaluated the biological rationale, mechanistic evidence, and biomarker potential of soluble innate immune receptors and their ligands in endometriosis. This review aims to address this gap.