Endometriosis and autoimmunity

Noémie Abisror, Kamila Kolańska, M. Cheloufi, Lise Selleret, Emmanuelle Mathieu d’Argent, Gilles Kayem, A. Mékinian
In: Exploration of Immunology · 2022 · pp. 25–31 · doi:10.37349/ei.2022.00034 · W4213325692
article OA: diamond CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This paper reviews the association between autoimmune markers and diseases in endometriosis, suggesting a potential role for immunomodulatory therapies in managing the condition, particularly regarding infertility.

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

This perspective article reviews evidence that endometriosis, described as an estrogen-dependent inflammatory disease, is associated with a higher prevalence of systemic autoimmune diseases (including SLE, rheumatoid arthritis, celiac disease, inflammatory bowel disease, Sjögren’s syndrome, and autoimmune thyroiditis) and with increased autoantibodies in blood and peritoneal fluids, even when overt autoimmune disease is absent. It summarizes multiple case-control and population-based studies reporting increased risk of autoimmune conditions after endometriosis, and discusses a wide array of detected autoantibodies, noting that their clinical relevance and ability to predict infertility outcomes remain unclear and may be limited by biases and inconsistent stage correlations. The paper also considers immunomodulatory therapies as a potential alternative or adjunct to hormonal and surgical management, while emphasizing the need for prospective, well-designed trials. This paper is centrally about endometriosis — it focuses on how autoimmune diseases and autoantibodies may relate to endometriosis pathophysiology and infertility and to prospects for immunomodulatory therapy.

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Abstract

Endometriosis is an inflammatory oestrogen-dependent chronic disease and is mainly expressed by pain and increased infertility. Several studies showed an increased prevalence of autoimmune systemic diseases and various autoantibodies in endometriosis. The association of these autoimmune markers and diseases could raise the fact that endometriosis is an authentic autoimmune or inflammatory disease and thus could argue for the use of immunomodulatory therapies. Usually, it is considered that the autoantibodies did not directly act in endometrium implants growth, and could be rather implicated in endometriosis-related infertility. The use of immunomodulatory strategies could be an important alternative or additional strategy to the use of hormones and surgery but need prospective well-designed trials.

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Condition tags

endometriosisinfertility

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