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Review

Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review)

  • Authors:
    • Wanmeng Chen
    • Yujiu Ma
    • Xudong Zhang
    • Siwen Zhang
    • Shanshan Wu
    • Yimeng Lu
    • Jichun Tan
  • View Affiliations / Copyright

    Affiliations: Department of Obstetrics and Gynecology, Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, P.R. China
  • Article Number: 32
    |
    Published online on: December 1, 2025
       https://doi.org/10.3892/ijmm.2025.5703
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Abstract

Endometriosis is a complex, chronic inflammatory gynecological disorder with estrogen‑dependent characteristics that severely impairs the quality of life of women and potentially leads to infertility. However, its pathogenesis remains poorly understood. Exosomes, small, discoid vesicles released by nearly all cell types, serve essential functions in multiple biological processes, including immune evasion, cellular migration, and differentiation. These vesicles can transport a broad repertoire of bioactive molecules, cross cell membranes readily, and remain stable within cells and body fluids. The present review summarizes global research from the last two decades on the mechanistic associations between exosomes and endometriosis, emphasizing their potential as vehicles for therapeutic delivery. Notably, the biological hallmarks of endometriosis such as fibrosis, immune dysregulation, angiogenesis, and aberrant cellular proliferation and migration, align with exosomal functions, suggesting that exosomes may contribute to disease progression. Furthermore, the use of exosomes as natural carriers for endometriosis treatment has been proposed, suggesting novel therapeutic avenues.
View Figures

Figure 1

Endometriosis mechanism map. This
chart integrates several key pathogenic mechanisms of endometriosis
and elucidates the process of formation, survival, and pathological
effects of ectopic endometrial tissue in the pelvis. The retrograde
implantation theory proposes that endometrial fragments reflux
through the fallopian tubes during menstruation and adhere to the
peritoneal or ovarian surfaces. The metaplastic theory suggests
that epithelial cells, including peritoneal and ovarian cells,
transform into endometrioid cells under inflammation or hormonal
stimulation. The vascular and lymphatic spreading theory posits
that endometrial cells migrate through the vascular or lymphatic
systems to distant organs (such as the lungs, stomach or kidneys).
In addition, ectopic endometriotic tissue at ovarian or peritoneal
sites exhibits luteinizing hormone resistance, with endothelium
dominated by PRA subtypes and an elevated PRA/PRB ratio, leading to
defective decidual transformation. Finally, immune imbalance in
which immune surveillance is diminished and hyperinflammatory
response is enhanced, leads to an in vivo immune imbalance.
PRA, progesterone receptor A; PRB, progesterone receptor B; NK,
natural killer; IL, interleukin; CXCCL12, C-X-C motif chemokine
ligand 12.

Figure 2

Functional roles of exosomes from
various cell sources. Exosomes originating from diverse cell types
including immune cells, stem cells, glial cells, epithelial cells,
and endothelial cells hold immense potential in medical
applications. They play crucial roles in disease diagnosis,
therapeutic strategies, and drug delivery systems.
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Copy and paste a formatted citation
Spandidos Publications style
Chen W, Ma Y, Zhang X, Zhang S, Wu S, Lu Y and Tan J: Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review). Int J Mol Med 57: 32, 2026.
APA
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., & Tan, J. (2026). Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review). International Journal of Molecular Medicine, 57, 32. https://doi.org/10.3892/ijmm.2025.5703
MLA
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., Tan, J."Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review)". International Journal of Molecular Medicine 57.2 (2026): 32.
Chicago
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., Tan, J."Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review)". International Journal of Molecular Medicine 57, no. 2 (2026): 32. https://doi.org/10.3892/ijmm.2025.5703
Copy and paste a formatted citation
x
Spandidos Publications style
Chen W, Ma Y, Zhang X, Zhang S, Wu S, Lu Y and Tan J: Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review). Int J Mol Med 57: 32, 2026.
APA
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., & Tan, J. (2026). Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review). International Journal of Molecular Medicine, 57, 32. https://doi.org/10.3892/ijmm.2025.5703
MLA
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., Tan, J."Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review)". International Journal of Molecular Medicine 57.2 (2026): 32.
Chicago
Chen, W., Ma, Y., Zhang, X., Zhang, S., Wu, S., Lu, Y., Tan, J."Bridging bench to bedside: Exosome‑based strategies for endometriosis diagnosis and treatment (Review)". International Journal of Molecular Medicine 57, no. 2 (2026): 32. https://doi.org/10.3892/ijmm.2025.5703
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