T Cell Immunity in Pathogenesis, Progression, and Malignant Transformation of Endometriosis

Kana Wang, Kunang Liu, Zelan Liao, Zhimin Liao, Zongbing You
In: Serican Journal of Medicine · 2025 · vol. 2(2) · doi:10.17161/sjm.v2i2.23662 · W4408643907
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This review examines how various T cell subsets influence the development, progression, and malignant transformation of endometriosis, highlighting potential immunomodulatory therapeutic strategies.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This paper reviews how T cell–mediated immunity contributes to endometriosis pathogenesis, progression, and malignant transformation, focusing on the immune microenvironment shaped by CD4+ T cell subsets (including Th1/Th2/Th17, Treg, Tfh, and Th9) and CD8+ T cells. It synthesizes evidence that imbalances among these T cell populations can promote chronic inflammation, immune evasion, and tissue remodeling, processes proposed to increase malignant risk in endometriosis-associated ovarian cancer. The authors note that endometriosis progression to malignancy is multifactorial, with genetic, environmental, and hormonal factors alongside immuno-inflammatory mechanisms, and they frame their content as a review rather than presenting new experimental results. This paper is centrally about endometriosis — it specifically examines T cell immunity in its progression and malignant transformation.

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Abstract

Endometriosis is a common gynecological condition characterized by special features such as invasive growth, recurrence, and potential distant metastasis. Recent studies indicate an increasing incidence of malignant transformation of endometriosis. The mechanisms underlying the occurrence, progression, and malignancy of endometriosis are multifactorial, involving genetic alterations, environmental factors, hormonal imbalances, and immuno-inflammatory responses. Various T cell subsets play crucial roles in regulating immune responses and influencing disease progression and malignant risk. CD4+ T cells, including T helper (Th) cells (Th1, Th2, and Th17), regulatory T (Treg) cells, follicular helper T (Tfh) cells, and Th9 cells, alongside CD8+ T cells are essential for maintaining the immune microenvironment in endometriosis. Disruption of the balance among these T cell subtypes can promote chronic inflammation, immune evasion, and tissue remodeling that may facilitate malignant transformation. Therapeutic strategies targeting T cell function or restoring immune homeostasis hold promise for managing endometriosis through immunomodulation or checkpoint blockade therapy to prevent its malignant progression. This article reviews the role of T cells in the malignant transformation of endometriosis and proposes potential immunoregulatory treatment approaches.
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T Cell Immunity in Pathogenesis, Progression, and Malignant Transformation of Endometriosis DOI: https://doi.org/10.17161/sjm.v2i2.23662Keywords: Endometriosis, malignant transformation, endometriosis-associated ovarian cancer, CD4+ T cells, CD8+ T cells, immune microenvironment, T cell imbalance; immunotherapyAbstract Endometriosis is a common gynecological condition characterized by special features such as invasive growth, recurrence, and potential distant metastasis. Recent studies indicate an increasing incidence of malignant transformation of endometriosis. The mechanisms underlying the occurrence, progression, and malignancy of endometriosis are multifactorial, involving genetic alterations, environmental factors, hormonal imbalances, and immuno-inflammatory responses. Various T cell subsets play crucial roles in regulating immune responses and influencing disease progression and malignant risk. CD4+ T cells, including T helper (Th) cells (Th1, Th2, and Th17), regulatory T (Treg) cells, follicular helper T (Tfh) cells, and Th9 cells, alongside CD8+ T cells are essential for maintaining the immune microenvironment in endometriosis. Disruption of the balance among these T cell subtypes can promote chronic inflammation, immune evasion, and tissue remodeling that may facilitate malignant transformation. Therapeutic strategies targeting T cell function or restoring immune homeostasis hold promise for managing endometriosis through immunomodulation or checkpoint blockade therapy to prevent its malignant progression. This article reviews the role of T cells in the malignant transformation of endometriosis and proposes potential immunoregulatory treatment approaches. Downloads Published Data Availability Statement All data contained in the text. Issue Section License Copyright (c) 2025 Kana Wang, Kunang Liu, Zelan Liao, Zongbing You (Author) This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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