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

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.