{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:41:02Z","timestamp":1790811662161,"version":"4.1.0"},"reference-count":95,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T00:00:00Z","timestamp":1686441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Natural Science Foundation of China","award":["82071623"],"award-info":[{"award-number":["82071623"]}]},{"name":"National Natural Science Foundation of China","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["82071623"],"award-info":[{"award-number":["82071623"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>As understanding their pathogenesis remains elusive, both endometriosis and adenomyosis are often referred to as \u201cenigmatic diseases\u201d. The uncertainty and heightened interest are reflected in the range of expressed views and opinions. There is a sense of urgency because of the entailed patient suffering. The plethora of opinions calls for a critical analysis of proposed theories, both old and new. A series of papers published since 2009 proposed that both endometriosis and adenomyosis originate from the same aberrations occurring within the uterus. This came to be recognized as the tissue injury and repair theory, and the newly coined term \u201carchimetrosis\u201d posits that the two diseases share the same origin. While the theory opens an interesting channel for exploration, its claim as a unifying theory necessitates a critical appraisal. We, thus, undertook this review of the theory and analyzed its underpinnings based on a comprehensive review of the literature. Our appraisal indicates that the theory is open to a range of criticisms. Chief among these is the need for confirmatory evidence of features of abnormal uterine contractility and the lack of data addressing the question of causality. In addition, the theory has, as yet, no supporting epidemiological evidence, which is a major weakness. The theory suffers as it is not open to the test of falsifiability, and it lacks the ability to make useful predictions. It has not addressed the questions, such as why only a small percentage of women develop adenomyosis or endometriosis, given the ubiquity of uterine peristalsis. On the other hand, the triggers and prevention of hyper- or dys-peristalsis become critical to a theory of causation. We conclude that additional supportive evidence is required for the theory to be accepted.<\/jats:p>","DOI":"10.3390\/biom13060975","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T03:02:27Z","timestamp":1686538947000},"page":"975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["An Appraisal of the Tissue Injury and Repair (TIAR) Theory on the Pathogenesis of Endometriosis and Adenomyosis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5404-252X","authenticated-orcid":false,"given":"Marwan","family":"Habiba","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Leicester and University Hospitals of Leicester, Leicester LE1 5WW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-4594","authenticated-orcid":false,"given":"Giuseppe","family":"Benagiano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Sapienza, University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-7624","authenticated-orcid":false,"given":"Sun-Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"Research Institute, Shanghai Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, China"},{"name":"Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Fudan University, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1055\/s-0040-1713429","article-title":"Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics","volume":"38","author":"Filby","year":"2020","journal-title":"Semin. 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