Vascular involvement in endometriosis and adenomyosis (reply to letter to the editor)

Linda C Giudice, Binya Liu, Juan C Irwin
American journal of obstetrics and gynecology · 2025 · vol. 234(6) , pp. e241 · doi:10.1016/j.ajog.2025.12.047 · PMID:41423009
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This letter to the editor clarifies the role of vascular involvement in endometriosis and adenomyosis, responding to a previous publication.

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This is a reply to a letter to the editor addressing an earlier review on vascular involvement in endometriosis and adenomyosis, with the authors stating that their review first compared clinical characteristics that are shared and discordant between the two disorders. They then reviewed recent single-cell–resolution literature on both eutopic and ectopic endometrium in these conditions, focusing on cell types and subtypes, activation states and progenitors, signaling pathways, cell–cell communication, and trajectories of cell transdifferentiation, along with opportunities and challenges for drug discovery. The reply does not provide new experimental data beyond the framing of how the authors synthesized prior work and appears limited in that it is a narrative review/reply rather than an original study. This paper is centrally about endometriosis — and adenomyosis — as a vascular-focused review and editorial response comparing the disorders and integrating single-cell findings about their endometrial tissues.

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Vascular involvement in endometriosis and adenomyosis (reply to letter to the editor) Affiliations & Notes Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA 94143 Article Info Publication History: Published online December 18, 2025 Footnotes: The authors report no conflict of interest. This study was supported by the National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number: P01 HD 106414). DOI: 10.1016/j.ajog.2025.12.047 External LinkAlso available on ScienceDirect External Link Copyright: © 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Linked Articles - Vascular involvement in endometriosis and adenomyosisAmerican Journal of Obstetrics & GynecologyVol. 234Issue 6December 18, 2025 Download started OkThe authors would like to thank Drs Gupta and Pai for their letter to the editors related to our recent article.1,2 In our review, we focused first on clinical characteristics shared and discordant between endometriosis and adenomyosis—“sister disorders of the endometrium but not identical twins.” Next, we reviewed the most recent literature on the eutopic endometrium and the ectopic endometrium at single-cell resolution in these disorders that have provided huge insights into the major cell types and subtypes, activation states, and progenitors in these tissues, signaling pathways, cell-cell communications, trajectories of cell transdifferentiation, and opportunities for novel drug discovery and challenges that accompany this type of research. References 1. Gupta, S. ∙ Pai, S.A. Vascular involvement in endometriosis and adenomyosis Am J Obstet Gynecol. 2026; 234:e240 2. Giudice, L.C. ∙ Liu, B. ∙ Irwin, J.C. Endometriosis and adenomyosis unveiled through single-cell glasses Am J Obstet Gynecol. 2025; 232:S105-S123 3. Sampson, J.A. Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation Am J Pathol. 1927; 3:93-110.43 4. Fitzpatrick, M.B. ∙ Hammer, P.M. ∙ Yang, E.J. ... Intravascular adenomyomatosis: a morphologic variant of intravenous leiomyomatosis associated with endometriosis and potential for misdiagnosis Hum Pathol. 2022; 120:18-25 5. Habiba, M. ∙ Ruscito, I. ∙ Bianchi, P. ... Is adenomyosis associated with systemic vascular complications? Reprod Med. 2025; 6:38

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endometriosisadenomyosis

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