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Autophagy plays vital roles in endometriosis and influences endometrial cell metastasis, and hypoxia was identified as the initiator of this pathological process through hypoxia inducible factor 1 alpha (HIF\u20101\u03b1). A newly discovered circular RNA\n                    <jats:italic>FOXO3<\/jats:italic>\n                    (\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    ) is critical in cell autophagy, migration, and invasion of various diseases and is reported to be related to hypoxia, although its role in endometriosis remains to be elucidated up to now. In this study, a lower\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    expression in ectopic endometrium was investigated. Furthermore, we verified that\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    could regulate autophagy by downregulating the level of p53 protein to mediate the migration and invasion of human endometrial stromal cells (T HESCs). Additionally, the effects of HIF\u20101\u03b1 on\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    and autophagy were examined in T HESCs. Notably, overexpression of HIF\u20101\u03b1 could induce autophagy and inhibit\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    expression, whereas overexpressing of\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    under hypoxia significantly inhibited hypoxia\u2010induced autophagy. Mechanistically, the direct combination between HIF\u20101\u03b1 and HIF\u20101\u03b1\u2010binding site on adenosine deaminase 1 acting on RNA (\n                    <jats:italic>ADAR1<\/jats:italic>\n                    ) promoter increased the level of ADAR1 protein, which bind directly with\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    pre\u2010mRNA to block the cyclization of\n                    <jats:italic>circFOXO3.<\/jats:italic>\n                    All these results support that hypoxia\u2010mediated ADAR1 elevation inhibited the expression of\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    , and then autophagy was induced upon loss of\n                    <jats:italic>circFOXO3<\/jats:italic>\n                    via inhibition of p53 degradation, participating in the development of endometriosis.\n                  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