{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:37:42Z","timestamp":1792798662848,"version":"4.5.0"},"reference-count":142,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>Endometriosis is widely recognized as a chronic, inflammatory, and heterogeneous condition that can manifest in various anatomical locations within females. It is marked by estrogen-driven cycles of bleeding, cell proliferation, and fibrosis involving ectopic endometrial glands and stroma cells located outside the uterus. The limited understanding of its etiology and complex pathogenesis has created obstacles in achieving early diagnosis and developing effective treatments with minimal side effects. Consequently, endometriosis requires more in-depth research to unravel its pathogenesis. The gut microbiota, a key player in chronic diseases, significantly influences bodily metabolism and immune regulation. Emerging evidence links the gut microbiota to inflammation, estrogen metabolism, and immune responses\u2014key factors in the onset and progression of endometriosis. This review examines the various mechanisms through which endometriosis and the gut microbiota interact, aiming to inspire new strategies for preventing and early treating endometriosis.<\/jats:p>","DOI":"10.3389\/fcimb.2025.1526063","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T01:27:00Z","timestamp":1751851620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of gut microbiota on endometriosis: linking physical injury to mental health"],"prefix":"10.3389","volume":"15","author":[{"given":"Li","family":"Yuanyue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liufeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Xiaomei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.693118","article-title":"The inflammatory feed-forward loop triggered by the complement component C3 as a potential target in endometriosis","volume":"12","author":"Agostinis","year":"2021","journal-title":"Front. Immunol."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1261781","article-title":"Estrobolome dysregulation is associated with altered immunometabolism in a mouse model of endometriosis","volume":"14","author":"Alghetaa","year":"2023","journal-title":"Front. Endocrinol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"E363","DOI":"10.1503\/cmaj.220637","article-title":"Diagnosis and management of endometriosis","volume":"195","author":"Allaire","year":"2023","journal-title":"Can. Med. Assoc. J."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.1016\/j.fertnstert.2005.05.066","article-title":"Changes in the T-helper cytokine profile and in lymphocyte activation at the systemic and local levels in women with endometriosis","volume":"84","author":"Antsiferova","year":"2005","journal-title":"Fertil. Steril."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.1016\/j.pain.2012.01.032","article-title":"Changes in regional gray matter volume in women with chronic pelvic pain: A voxel-based morphometry study","volume":"153","author":"As-Sanie","year":"2012","journal-title":"Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jpain.2015.09.008","article-title":"Functional connectivity is associated with altered brain chemistry in women with endometriosis-associated chronic pelvic pain","volume":"17","author":"As-Sanie","year":"2016","journal-title":"J. Pain."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1038\/s41598-019-39700-6","article-title":"The endobiota study: comparison of vaginal, cervical and gut microbiota between women with stage 3\/4 endometriosis and healthy controls","volume":"9","author":"Ata","year":"2019","journal-title":"Sci. Rep."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1093\/humrep\/17.7.1704","article-title":"Endometriosis is associated with an altered profile of intestinal microflora in female rhesus monkeys","volume":"17","author":"Bailey","year":"2002","journal-title":"Hum. Reprod."},{"key":"B9","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen\u2013gut microbiome axis: Physiological and clinical implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2023.1295983","article-title":"Diet associations in endometriosis: a critical narrative assessment with special reference to gluten","volume":"10","author":"Brouns","year":"2023","journal-title":"Front. Nutr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1210\/er.2018-00242","article-title":"Endometriosis","volume":"40","author":"Bulun","year":"2019","journal-title":"Endocr. Rev."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3687498","DOI":"10.1155\/2020\/3687498","article-title":"Letrozole and the traditional chinese medicine, shaofu zhuyu decoction, reduce endometriotic disease progression in rats: A potential role for gut microbiota","volume":"2020","author":"Cao","year":"2020","journal-title":"Evid. Based. Complement. Alternat. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1093\/humrep\/dez041","article-title":"Antibiotic therapy with metronidazole reduces endometriosis disease progression in mice: a potential role for gut microbiota","volume":"34","author":"Chadchan","year":"2019","journal-title":"Hum. Reprod."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41420-023-01309-0","article-title":"Gut microbiota and microbiota-derived metabolites promotes endometriosis","volume":"9","author":"Chadchan","year":"2023","journal-title":"Cell Death Discov."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.26508\/lsa.202101224","article-title":"Gut microbiota\u2013derived short-chain fatty acids protect against the progression of endometriosis","volume":"4","author":"Chadchan","year":"2021","journal-title":"Life Sci. Alliance."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e2666","DOI":"10.1038\/cddis.2017.95","article-title":"IL-27 triggers IL-10 production in Th17 cells via a c-Maf\/ROR\u03b3t\/Blimp-1 signal to promote the progression of endometriosis","volume":"8","author":"Chang","year":"2017","journal-title":"Cell Death Dis."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-017-00901-0","article-title":"The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases","volume":"8","author":"Chen","year":"2017","journal-title":"Nat. Commun."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1134663","article-title":"Peritoneal immune microenvironment of endometriosis: Role and therapeutic perspectives","volume":"14","author":"Chen","year":"2023","journal-title":"Front. Immunol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1177\/1933719118808923","article-title":"Alteration of myeloid-derived suppressor cells, chronic inflammatory cytokines, and exosomal miRNA contribute to the peritoneal immune disorder of patients with endometriosis","volume":"26","author":"Chen","year":"2019","journal-title":"Reprod. Sci."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/ijms241914601","article-title":"Mediterranean diet and oxidative stress: A relationship with pain perception in endometriosis","volume":"24","author":"Cirillo","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11010039","article-title":"The emerging role of menstrual-blood-derived stem cells in endometriosis","volume":"11","author":"Cordeiro","year":"2022","journal-title":"Biomedicines"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25126473","article-title":"Endometriosis, pain, and related psychological disorders: unveiling the interplay among the microbiome, inflammation, and oxidative stress as a common thread","volume":"25","author":"Cuffaro","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1111\/j.1574-6941.2008.00520.x","article-title":"Distribution of \u03b2-glucosidase and \u03b2-glucuronidase activity and of \u03b2-glucuronidase gene gus in human colonic bacteria","volume":"66","author":"Dabek","year":"2008","journal-title":"FEMS Microbiol. Ecol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jri.2017.04.003","article-title":"What do we know about regulatory T cells and endometriosis? A systematic review","volume":"120","author":"de Barros","year":"2017","journal-title":"J. Reprod. Immunol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1093\/jsxmed\/qdae084","article-title":"Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates","volume":"21","author":"Ding","year":"2024","journal-title":"J.\u00a0Sexual. Med."},{"key":"B26","doi-asserted-by":"publisher","first-page":"103112","DOI":"10.1016\/j.arcmed.2024.103112","article-title":"Influence of hormonal factors, number of sexual partners, surgical intervention on gastrointestinal and urogenital microbiota of patients endometriosis","volume":"55","author":"Do","year":"2024","journal-title":"Arch. Med. Res."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1186\/s12958-018-0385-3","article-title":"The dynamic changes in the number of uterine natural killer cells are specific to the eutopic but not to the ectopic endometrium in women and in a baboon model of endometriosis","volume":"16","author":"Drury","year":"2018","journal-title":"Reprod. Biol. Endocrinol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.rbmo.2018.05.017","article-title":"The M2a macrophage subset may be critically involved in the fibrogenesis of endometriosis in mice","volume":"37","author":"Duan","year":"2018","journal-title":"Reprod. BioMedi. Online."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.16195","article-title":"Evaluation of serum and peritoneal fluid mannose-binding lectin associated serine protease-3, adipsin, properdin, and complement factor-H levels in endometriosis patients","author":"E\u015fkin Tanr\u0131verdi","year":"2025","journal-title":"Int. J. Gynecol. Obstet"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1897","DOI":"10.1097\/CM9.0000000000002649","article-title":"Understanding endometriosis from an immunomicroenvironmental perspective","volume":"136","author":"Fan","year":"2023","journal-title":"Chin. Med. J"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2024.2392009","article-title":"Microbiota during pregnancy and early life: role in maternal\u2013neonatal outcomes based on human evidence","volume":"16","author":"Fasano","year":"2024","journal-title":"Gut. Microbes"},{"key":"B32","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1479-5876-10-253","article-title":"Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study","volume":"10","author":"Flores","year":"2012","journal-title":"J. Transl. Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1038\/s41588-022-01254-1","article-title":"Single-cell transcriptomic analysis of endometriosis","volume":"55","author":"Fonseca","year":"2023","journal-title":"Nat. Genet."},{"key":"B34","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.nbd.2012.03.012","article-title":"How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans","volume":"52","author":"Frodl","year":"2013","journal-title":"Neurobiol. Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"536.e531","DOI":"10.1016\/j.ajog.2023.07.033","article-title":"Associations between endometriosis and common symptoms: findings from the Australian Longitudinal Study on Women\u2019s Health","volume":"229","author":"Gete","year":"2023","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jri.2016.04.289","article-title":"Increased percentage of Th17 cells in peritoneal fluid is associated with severity of endometriosis","volume":"117","author":"Gogacz","year":"2016","journal-title":"J. Reprod. Immunol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"e0226835","DOI":"10.1371\/journal.pone.0226835","article-title":"Effect of endometriosis on the fecal bacteriota composition of mice during the acute phase of lesion formation","volume":"14","author":"Hantschel","year":"2019","journal-title":"PloS One"},{"key":"B38","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1111\/1471-0528.17979","article-title":"Oral, vaginal, and stool microbial signatures in patients with endometriosis as potential diagnostic non-invasive biomarkers: A prospective cohort study","volume":"132","author":"Hicks","year":"2024","journal-title":"BJOG"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070750","article-title":"Pathophysiology, diagnosis, and management of endometriosis","volume":"379","author":"Horne","year":"2022","journal-title":"Bmj"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.788836","article-title":"Gut microbiota exceeds cervical microbiota for early diagnosis of endometriosis","volume":"11","author":"Huang","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1007\/s10616-010-9326-5","article-title":"Lactobacillus gasseri OLL2809 is effective especially on the menstrual pain and dysmenorrhea in endometriosis patients: randomized, double-blind, placebo-controlled study","volume":"63","author":"Itoh","year":"2010","journal-title":"Cytotechnology"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1097\/j.pain.0000000000000517","article-title":"Brain activations during pain","volume":"157","author":"Jensen","year":"2016","journal-title":"Pain"},{"key":"B43","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/ALN.0000000000002130","article-title":"Neuroinflammation and central sensitization in chronic and widespread pain","volume":"129","author":"Ji","year":"2018","journal-title":"Anesthesiology"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22115644","article-title":"Intricate connections between the microbiota and endometriosis","volume":"22","author":"Jiang","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03500-1","article-title":"Vaginal and rectal microbiome contribute to genital inflammation in chronic pelvic pain","volume":"22","author":"Jimenez","year":"2024","journal-title":"BMC Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1016\/j.fertnstert.2006.12.061","article-title":"Levels of complement components iC3b, C3c, C4, and SC5b-9 in peritoneal fluid and serum of infertile women with endometriosis","volume":"88","author":"Kabut","year":"2007","journal-title":"Fertil. Steril."},{"key":"B47","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.clinbiochem.2020.04.005","article-title":"Evaluation of complement system proteins C3a, C5a and C6 in patients of endometriosis","volume":"81","author":"Karadadas","year":"2020","journal-title":"Clin. Biochem."},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2023.10.008","article-title":"Roles of diet-associated gut microbial metabolites on brain health: cell-to-cell interactions between gut bacteria and the central nervous system","volume":"15","author":"Kim","year":"2024","journal-title":"Adv. Nutr."},{"key":"B49","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.fertnstert.2018.10.013","article-title":"Pathogenesis of endometriosis: the genetic\/epigenetic theory","volume":"111","author":"Koninckx","year":"2019","journal-title":"Fertil. Steril."},{"key":"B50","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.tem.2018.10.006","article-title":"Crosstalk between estrogen signaling and breast cancer metabolism","volume":"30","author":"Kulkoyluoglu-Cotul","year":"2019","journal-title":"Trends Endocrinol. Metab."},{"key":"B51","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/jnci\/djw029","article-title":"The intestinal microbiome and estrogen receptor\u2013positive female breast cancer","volume":"108","author":"Kwa","year":"2016","journal-title":"J. Natl. Cancer Inst."},{"key":"B52","doi-asserted-by":"publisher","first-page":"323","DOI":"10.2147\/IJWH.S119729","article-title":"Anxiety and depression in patients with endometriosis: impact and management challenges","volume":"9","author":"Lagan\u00e0","year":"2017","journal-title":"Int. J. Women\u2019s. Health"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24054254","article-title":"The main theories on the pathogenesis of endometriosis","volume":"24","author":"Lamceva","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B54","doi-asserted-by":"publisher","first-page":"e0261362","DOI":"10.1371\/journal.pone.0261362","article-title":"Association of microbial dynamics with urinary estrogens and estrogen metabolites in patients with endometriosis","volume":"16","author":"Le","year":"2021","journal-title":"PloS One"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1038\/s41598-022-05499-y","article-title":"Effects of endometriosis on immunity and mucosal microbial community dynamics in female olive baboons","volume":"12","author":"Le","year":"2022","journal-title":"Sci. Rep."},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2023.108435","article-title":"Prolactin and pain of endometriosis","volume":"247","author":"Lee","year":"2023","journal-title":"Pharmacol. Ther."},{"key":"B57","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1677\/joe.1.06781","article-title":"Tumor necrosis factor \u03b1 reversibly disrupts the blood\u2013testis barrier and impairs Sertoli\u2013germ cell adhesion in the seminiferous epithelium of adult rat testes","volume":"190","author":"Li","year":"2006","journal-title":"J.\u00a0Endocrinol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1016\/j.rbmo.2021.06.029","article-title":"Metabolite profiles in the peritoneal cavity of endometriosis patients and mouse models","volume":"43","author":"Li","year":"2021","journal-title":"Reprod. BioMedi. Online."},{"key":"B59","doi-asserted-by":"publisher","first-page":"4199","DOI":"10.2147\/JIR.S458928","article-title":"Gut microbiota disorder contributes to the production of IL-17A that exerts chemotaxis via binding to IL-17RA in endometriosis","volume":"17","author":"Li","year":"2024","journal-title":"J. Inflammation Res."},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2024.1386411","article-title":"Endometriosis is a disease of immune dysfunction, which could be linked to microbiota","volume":"15","author":"Liu","year":"2024","journal-title":"Front. Genet."},{"key":"B61","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1530\/REP-19-0028","article-title":"Elevated heme impairs macrophage phagocytosis in endometriosis","volume":"158","author":"Liu","year":"2019","journal-title":"Reproduction"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.3390\/molecules28020653","article-title":"UPLC-Q-TOF\/MS based plasma metabolomics for identification of paeonol\u2019s metabolic target in endometriosis","volume":"28","author":"Liu","year":"2023","journal-title":"Molecules"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2020.590823","article-title":"Pain in endometriosis","volume":"14","author":"Maddern","year":"2020","journal-title":"Front. Cell. Neurosci."},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175624","article-title":"Endometriosis and adolescence: the impact of dysmenorrhea","volume":"12","author":"Martire","year":"2023","journal-title":"J. Clin. Med."},{"key":"B65","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.fertnstert.2011.11.011","article-title":"Endometriosis-associated nerve fibers, peritoneal fluid cytokine concentrations, and pain in endometriotic lesions from different locations","volume":"97","author":"McKinnon","year":"2012","journal-title":"Fertil. Steril."},{"key":"B66","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/0002-9378(88)90369-9","article-title":"Autoimmunity in infertile patients with endometriosis","volume":"158","author":"Meek","year":"1988","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B67","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1177\/1933719118757682","article-title":"Circulating neutrophil extracellular traps are elevated in patients with deep infiltrating endometriosis","volume":"26","author":"Munr\u00f3s","year":"2019","journal-title":"Reprod. Sci."},{"key":"B68","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1126\/scitranslmed.add1531","article-title":"Fusobacterium infection facilitates the development of endometriosis through the phenotypic transition of endometrial fibroblasts","volume":"15","author":"Muraoka","year":"2023","journal-title":"Sci. Transl. Med."},{"key":"B69","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/j.jad.2023.11.034","article-title":"Endometriosis, chronic pain, anxiety, and depression: A retrospective study among 12 million women","volume":"346","author":"Nassiri Kigloo","year":"2024","journal-title":"J. Affect. Disord."},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14161822","article-title":"Exploring the influence of IL-8, IL-10, patient-reported pain, and physical activity on endometriosis severity","volume":"14","author":"Nati","year":"2024","journal-title":"Diagnostics"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13020444","article-title":"The prevalence of endometriosis in patients with unexplained infertility","volume":"13","author":"Nezhat","year":"2024","journal-title":"J. Clin. Med."},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1016\/j.chemosphere.2021.130952","article-title":"Bisphenol A impairs cognitive function and 5-HT metabolism in adult male mice by modulating the microbiota-gut-brain axis","volume":"282","author":"Ni","year":"2021","journal-title":"Chemosphere"},{"key":"B73","doi-asserted-by":"publisher","first-page":"e13307","DOI":"10.1111\/aji.13307","article-title":"Correlation of fecal metabolomics and gut microbiota in mice with endometriosis","volume":"84","author":"Ni","year":"2020","journal-title":"Am. J. Reprod. Immunol."},{"key":"B74","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1517\/14656566.2014.925446","article-title":"Treatment of central sensitization in patients with \u2018unexplained\u2019 chronic pain: an update","volume":"15","author":"Nijs","year":"2014","journal-title":"Expert Opin. Pharmacother."},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14030312","article-title":"Endometriosis and the role of pro-inflammatory and anti-inflammatory cytokines in pathophysiology: A narrative review of the literature","volume":"14","author":"Oal\u0103","year":"2024","journal-title":"Diagnostics"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25115815","article-title":"The known, the unknown and the future of the pathophysiology of endometriosis","volume":"25","author":"Ochoa Bernal","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B77","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1600-0897.2010.00887.x","article-title":"Lymphocytes in endometriosis","volume":"65","author":"Osuga","year":"2011","journal-title":"Am. J. Reprod. Immunol."},{"key":"B78","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1016\/S0002-9378(11)91433-1","article-title":"Effects of danazol at the immunologic level in patients with adenomyosis, with special reference to autoantibodies: A multi-center cooperative study","volume":"167","author":"Ota","year":"1992","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B79","doi-asserted-by":"publisher","DOI":"10.3390\/ijms242216301","article-title":"Gut\u00a0microbiome\u2013estrobolome profile in reproductive-age women with endometriosis","volume":"24","author":"Pai","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2023.117563","article-title":"Biomarkers of endometriosis","volume":"549","author":"Pant","year":"2023","journal-title":"Clin. Chim. Acta"},{"key":"B81","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1111\/aogs.13156","article-title":"Progesterone resistance in endometriosis: origins, consequences and interventions","volume":"96","author":"Patel","year":"2017","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-024-03503-y","article-title":"Gut microbiome in endometriosis: a cohort study on 1000 individuals","volume":"22","author":"P\u00e9rez-Prieto","year":"2024","journal-title":"BMC Med."},{"key":"B83","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1093\/humrep\/del516","article-title":"Endometriosis: an inflammatory disease with a Th2 immune response comp onent","volume":"22","author":"Podgaec","year":"2007","journal-title":"Hum. Reprod. (Oxford. England)."},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2024.106627","article-title":"Microbiota-gut-brain axis in perioperative neurocognitive and depressive disorders: Pathogenesis to treatment","volume":"200","author":"Que","year":"2024","journal-title":"Neurobiol. Dis."},{"key":"B85","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1007\/s00404-011-2063-y","article-title":"Endometriosis: the consequence of uterine denervation\u2013reinnervation","volume":"284","author":"Quinn","year":"2011","journal-title":"Arch. Gynecol. Obstet."},{"key":"B86","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1002\/acn3.51360","article-title":"Plasma calcitonin gene-related peptide (CGRP) in migraine and endometriosis during the menstrual cycle","volume":"8","author":"Raffaelli","year":"2021","journal-title":"Ann. Clin. Trans. Neurol."},{"key":"B87","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/08820139.2023.2206436","article-title":"C5a serum levels in patients with endometriosis: A cross-sectional study","volume":"52","author":"Rahal","year":"2023","journal-title":"Immunol. Invest."},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.3390\/ijms221910792","article-title":"The role of peritoneal macrophages in endometriosis","volume":"22","author":"Ram\u00edrez-Pavez","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B89","doi-asserted-by":"publisher","first-page":"10141","DOI":"10.3390\/ijms251810141","article-title":"The role of NK and T cells in endometriosis","volume":"25","author":"Reis","year":"2024","journal-title":"Int. J. Mol. Sci."},{"key":"B90","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1093\/humrep\/dez071","article-title":"B lymphocytes inactivation by Ibrutinib limits endometriosis progression in mice","volume":"34","author":"Riccio","year":"2019","journal-title":"Hum. Reprod."},{"key":"B91","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1093\/humrep\/dez071","article-title":"Immunology of endometriosis","volume":"50","author":"Riccio","year":"2018","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"B92","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1038\/nri2515","article-title":"The gut microbiota shapes intestinal immune responses during health and disease","volume":"9","author":"Round","year":"2009","journal-title":"Nat. Rev. Immunol."},{"key":"B93","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1093\/humupd\/dmab035","article-title":"The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain","volume":"28","author":"Salliss","year":"2022","journal-title":"Hum. Reprod. Update."},{"key":"B94","doi-asserted-by":"publisher","first-page":"19384","DOI":"10.1002\/jcp.28666","article-title":"The role of inflammation, oxidative stress, angiogenesis, and apoptosis in the pathophysiology of endometriosis: Basic science and new insights based on gene expression","volume":"234","author":"Samimi","year":"2019","journal-title":"J. Cell. Physiol."},{"key":"B95","first-page":"93","article-title":"Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation","volume":"3","author":"Sampson","year":"1927","journal-title":"Am. J. Pathol."},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-024-06713-5","article-title":"Endometriotic lesions exhibit distinct metabolic signature compared to paired eutopic endometrium at the single-cell level","volume":"7","author":"Sarsenova","year":"2024","journal-title":"Commun. Biol."},{"key":"B97","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1016\/j.fertnstert.2022.02.012","article-title":"Presurgical blood metabolites and risk of postsurgical pelvic pain in young patients with endometriosis","volume":"117","author":"Sasamoto","year":"2022","journal-title":"Fertil. Steril."},{"key":"B98","doi-asserted-by":"publisher","first-page":"2807","DOI":"10.1016\/j.cell.2021.04.041","article-title":"Endometriosis: Etiology, pathobiology, and therapeutic prospects","volume":"184","author":"Saunders","year":"2021","journal-title":"Cell"},{"key":"B99","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101596","article-title":"Endometriosis: Improvements and challenges in diagnosis and symptom management","volume":"5","author":"Saunders","year":"2024","journal-title":"Cell Rep. Med."},{"key":"B100","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00404-021-06057-z","article-title":"Gut microbiota imbalance and its correlations with hormone and inflammatory factors in patients with stage 3\/4 endometriosis","volume":"304","author":"Shan","year":"2021","journal-title":"Arch. Gynecol. Obstet."},{"key":"B101","doi-asserted-by":"publisher","first-page":"769","DOI":"10.7150\/ijms.71972","article-title":"IL-17: an important pathogenic factor in endometriosis","volume":"19","author":"Shi","year":"2022","journal-title":"Int. J. Med. Sci."},{"key":"B102","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s00404-018-4754-0","article-title":"The role of complement components C1q, MBL and C1 inhibitor in pathogenesis of endometriosis","volume":"297","author":"Sikora","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"B103","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12622","article-title":"Abnormal peritoneal regulation of chemokine activation\u2014The role of IL-8 in pathogenesis of endometriosis","volume":"77","author":"Sikora","year":"2017","journal-title":"Am. J. Reprod. Immunol."},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111809","article-title":"Beyond physical pain: A large-scale cohort study on endometriosis trends and mental health correlates","volume":"182","author":"Sinai","year":"2024","journal-title":"J. Psychosom. Res."},{"key":"B105","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.4049\/jimmunol.2400018","article-title":"The dysregulated IL-23\/TH17 axis in endometriosis pathophysiology","volume":"212","author":"Sisnett","year":"2024","journal-title":"J.\u00a0Immunol."},{"key":"B106","doi-asserted-by":"publisher","DOI":"10.3390\/ijms221910554","article-title":"Endometriosis: epidemiology, classification, pathogenesis, treatment and genetics (Review of literature)","volume":"22","author":"Smolarz","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2024.104640","article-title":"Pain severity and depressive symptoms in endometriosis patients: mediation of negative body awareness and interoceptive self-regulation","volume":"25","author":"Spinoni","year":"2024","journal-title":"J. Pain"},{"key":"B108","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1177\/1933719114525267","article-title":"Dendritic cells attenuate the early establishment of endometriosis-like lesions in a murine model","volume":"21","author":"Stanic","year":"2014","journal-title":"Reprod. Sci."},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-024-02096-y","article-title":"Blood lipids mediate the effects of gut microbiome on endometriosis: a mendelian randomization study","volume":"23","author":"Su","year":"2024","journal-title":"Lipids Health Dis."},{"key":"B110","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1002\/path.5339","article-title":"IL-10 from plasmacytoid dendritic cells promotes angiogenesis in the early stage of endometriosis","volume":"249","author":"Suen","year":"2019","journal-title":"J. Pathol."},{"key":"B111","doi-asserted-by":"publisher","first-page":"6163","DOI":"10.1158\/1078-0432.CCR-14-1338","article-title":"Complement pathway is frequently altered in endometriosis and endometriosis-associated ovarian cancer","volume":"20","author":"Suryawanshi","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"B112","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1007\/s43032-021-00506-5","article-title":"Associations between endometriosis and gut microbiota","volume":"28","author":"Svensson","year":"2021","journal-title":"Reprod. Sci."},{"key":"B113","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/aji.12540","article-title":"Neutrophil depletion reduces endometriotic lesion formation in mice","volume":"76","author":"Takamura","year":"2016","journal-title":"Am. J. Reprod. Immunol."},{"key":"B114","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1093\/biolre\/ioz039","article-title":"Endometrial cells contribute to\u00a0preexisting endometriosis lesions in a mouse model of retrograde menstruation\u2020","volume":"100","author":"Tal","year":"2019","journal-title":"Biol. Reprod."},{"key":"B115","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1093\/biolre\/ioac147","article-title":"The gut microbiota: a double-edged sword in endometriosis","volume":"107","author":"Talwar","year":"2022","journal-title":"Biol. Reprod"},{"key":"B116","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/S0140-6736(21)00389-5","article-title":"Endometriosis is a chronic systemic disease: clinical challenges and novel innovations","volume":"397","author":"Taylor","year":"2021","journal-title":"Lancet"},{"key":"B117","doi-asserted-by":"publisher","first-page":"649.e641","DOI":"10.1016\/j.ajog.2024.01.023","article-title":"Endometriosis and mental health: a population-based cohort study","volume":"230","author":"Thiel","year":"2024","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B118","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2025.123427","article-title":"A possible association between low MBL\/lectin pathway functionality and microbiota dysbiosis in endometriosis patients","volume":"364","author":"Toffoli","year":"2025","journal-title":"Life Sci."},{"key":"B119","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/376231","article-title":"Endometriosis in a patient with mayer-rokitansky-k\u00fcster-hauser syndrome","volume":"2014","author":"Troncon","year":"2014","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"B120","doi-asserted-by":"publisher","first-page":"1718","DOI":"10.1016\/j.pain.2013.05.022","article-title":"Menstrual pain is associated with rapid structural alterations in the brain","volume":"154","author":"Tu","year":"2013","journal-title":"Pain"},{"key":"B121","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2024.104292","article-title":"Growing evidence that endometriosis is a systemic disease","volume":"49","author":"Tulandi","year":"2024","journal-title":"Reprod. BioMedi. Online."},{"key":"B122","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232113267","article-title":"The role of the human microbiome in the pathogenesis of pain","volume":"23","author":"Ustianowska","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"B123","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.1111\/aogs.14847","article-title":"Comparative analysis of endometrial, vaginal, and gut microbiota in patients with and without adenomyosis","volume":"103","author":"Vald\u00e9s-Bango","year":"2024","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"B124","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1093\/humupd\/dmz018","article-title":"The endometrial immune environment of women with endometriosis","volume":"25","author":"Vallv\u00e9-Juanico","year":"2019","journal-title":"Hum. Reprod. Update."},{"key":"B125","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1089\/jwh.2021.0021","article-title":"Depression, anxiety, and correlating factors in endometriosis: A systematic review and meta-analysis","volume":"31","author":"van Barneveld","year":"2022","journal-title":"J. Women\u2019s. Health"},{"key":"B126","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1136\/gutjnl-2024-333378","article-title":"What defines a healthy gut microbiome","volume":"73","author":"Van Hul","year":"2024","journal-title":"Gut"},{"key":"B127","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222313102","article-title":"Neurogenic inflammation in the context of endometriosis\u2014What do we know","volume":"22","author":"Velho","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B128","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s00404-016-4195-6","article-title":"Regulation of apoptotic pathways during endometriosis: from the molecular basis to the future perspectives","volume":"294","author":"Vetvicka","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"B129","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1016\/j.pain.2011.03.029","article-title":"Dysmenorrhoea is associated with central changes in otherwise healthy women","volume":"152","author":"Vincent","year":"2011","journal-title":"Pain"},{"key":"B130","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-12476-z","article-title":"Interplay between the human gut microbiome and host metabolism","volume":"10","author":"Visconti","year":"2019","journal-title":"Nat.\u00a0Commun."},{"key":"B131","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.3748\/wjg.v30.i12.1655","article-title":"Gut microbiota and female health","volume":"30","author":"Wang","year":"2024","journal-title":"World J. Gastroenterol."},{"key":"B132","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1450310","article-title":"The gut microbiota: emerging biomarkers and potential treatments for infertility-related diseases","volume":"14","author":"Wang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B133","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1093\/humrep\/dex067","article-title":"Synergistic effect of regulatory T cells and proinflammatory cytokines in angiogenesis in the endometriotic milieu","volume":"32","author":"Wang","year":"2017","journal-title":"Hum. Reprod."},{"key":"B134","doi-asserted-by":"publisher","first-page":"6","DOI":"10.26355\/eurrev_201805_14899","article-title":"Inflammatory cytokines IL-6, IL-10, IL-13, TNF-\u03b1 and peritoneal fluid flora were associated with infertility in patients with endometriosis","volume":"22","author":"Wang X. M","year":"2018","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"B135","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.610963","article-title":"Platelets and regulatory T cells may induce a type 2 immunity that is conducive to the progression and fibrogenesis of endometriosis","volume":"11","author":"Xiao","year":"2020","journal-title":"Front. Immunol."},{"key":"B136","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1021\/acs.jafc.4c03870","article-title":"Lacticaseibacillus rhamnosus KY16 improves depression by promoting intestinal secretion of 5-HTP and altering the gut microbiota","volume":"72","author":"Xie","year":"2024","journal-title":"J. Agric. Food Chem."},{"key":"B137","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.955581","article-title":"Electroacupuncture attenuates surgical pain-induced delirium-like behavior in mice via remodeling gut microbiota and dendritic spine","volume":"13","author":"Yang","year":"2022","journal-title":"Front. Immunol."},{"key":"B138","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1093\/humupd\/dmx016","article-title":"The role of TGF-\u03b2 in the pathophysiology of peritoneal endometriosis","volume":"23","author":"Young","year":"2017","journal-title":"Hum. Reprod. Update."},{"key":"B139","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-90112-x","article-title":"Multi-omics analysis reveals the interaction between the complement system and the coagulation cascade in the development of endometriosis","volume":"11","author":"Yu","year":"2021","journal-title":"Sci. Rep."},{"key":"B140","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1093\/humrep\/dex372","article-title":"Endometriosis induces gut microbiota alterations in mice","volume":"33","author":"Yuan","year":"2018","journal-title":"Hum. Reprod."},{"key":"B141","doi-asserted-by":"publisher","first-page":"2417179","DOI":"10.1080\/07853890.2024.2417179","article-title":"Limosilactobacillus-related 3-OMDP as a potential therapeutic target f or depression","volume":"56","author":"Zhong","year":"2024","journal-title":"Ann. Med."},{"key":"B142","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0008-5","article-title":"Endometriosis","volume":"4","author":"Zondervan","year":"2018","journal-title":"Nat. Rev. Dis. Primers"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1526063\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T01:27:01Z","timestamp":1751851621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1526063\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,7]]},"references-count":142,"alternative-id":["10.3389\/fcimb.2025.1526063"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1526063","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,7]]},"article-number":"1526063"}}