Xiaojun Liu 1†, Minghui Fan 1†, Yang Wang 2, Dongyun He

The gap

Evidence profile

Sourced from the future work of the source papers, classified as general, drawn from work published between 2024 and 2026, spanning 3 journals. Those papers have been cited 86 times in total.

Supporting evidence — 3 representative gaps

• Endometriosis, Pain, and Related Psychological Disorders: Unveiling the Interplay among the Microbiome, Inflammation, and Oxidative Stress as a Common Thread (2024) · International Journal of Molecular Sciences · cited 71× · doi

  To conclude, there is a complex relationship among endometriosis, pain, and psy- chological comorbidities such as stress, anxiety, neurological disorders, and depression. In truth, psychological symptoms usually coexist with physical ones, with CPP serving as a key mediator between endometriosis and these comorbidities. In addition, as the EM disease is characterized by chronic inflammation, it is crucial to delve into the role of the main modulators of inflammation, such as the microbiome (and its metabolites) Int. J. Mol. Sci. 2024, 25, 6473 19 of 29 and oxidative stress, in regulating CPP as well as psychological comorbidities. Recent evidence suggests that the microbiome influences pain modulation in both the peripheral nervous system and the CNS. Therefore, in the context of the existing literature, we propose that regulating bacterial flora via dietary adjustments and probiotics/prebiotics or similar interventions could offer a new therapeutic avenue for addressing CPP and psychological disorders. However, it is critical to note that while the research in this field is promis- ing, it is still in its early stages. The previous studies have several limitations, including heterogeneous study designs, small sample sizes, absence of control groups, and a lack of prospective research. More comprehensive and consistent clinical trials are needed to establish the safety and especially the efficacy of such interventions. Elucidation of the interplay among the microbiome, inflammation, and oxidative stress in endometriosis will be useful for limiting pain and improving the quality of life and mental health of patients. The new findings will be relevant and encouraging for the gynaecological community in the development of clinical and nutritional intervention protocols to maintain and support the mental well-being of patients. Author Contributions: Conceptualization, A.A., E.R. and F.C.; investigation, A.A., E.R. and F.C.; writing—original draft, F.C. and E.R.; writing—review and editing, A.A. and E.R.; funding acquisition, A.A.; supervision, A.A. All authors have read and agreed to the published version of the manuscript. Funding: Work supported by #NEXTGENERATIONEU (NGEU) and funded by the Ministry of University and Research (MUR), National Recovery and Resilience Plan (NRRP), and Project MNESYS (PE0000006)—a multiscale integrated approach to the study of the nervous system in health and disease (DR. 1553 11.10.2022). Conflicts of Interest: The authors declare no conflicts of interest.

  generalfuture work
  Keywords: endometriosis pain comorbidities stress psychological inflammation microbiome among disorders disease oxidative regulating well nervous system
• The Critical Role of Host and Bacterial Extracellular Vesicles in Endometriosis (2024) · Biomedicines · cited 10× · doi

  EVs and BEVs engage in a complex interplay between the microbiome and the immune system to potentially facilitate the progression of endometriosis and modulate the lesion microenvironment. EVs can influence both local and systemic environments, while BEVs promote inflammation and facilitate the growth of endometriosis lesions through protective mechanisms. EVs and BEVs can be collected and analysed from various biological samples and may offer a snapshot of the disease stage, which can be particularly powerful for the development of early diagnostic tools [59]. Their anti-microbial activity and anti- inflammatory effects can be potentially synergised to dampen the impact of endometriosis. Further research is warranted to explore the precise mechanisms by which BEVs and EVs contribute to the onset and/or progression of endometriosis. In addition, longitudinal studies characterising the dynamic release of these vesicles over the course of their cyclical flare ups would ascertain their biomarker potential in endometriosis and help with the development of scalable production for targeted treatments and improve outcomes for patients, particularly those with inflammation-related pain. Biomedicines 2024, 12, 2585 9 of 13 Author Contributions: Conceptualisation—F.E.-A.; writing—original draft, review and editing M.W., C.H. and F.E.-A.; writing—review and editing E.E.-O. and V.C. All authors have read and agreed to the published version of the manuscript. Funding: UNSW Career Advancement Fund to F.E.-A. Conflicts of Interest: The authors declare no conflicts of interest.

  generalfuture work
  Keywords: endometriosis bevs potentially facilitate progression inflammation mechanisms particularly development anti writing review editing authors conflicts
• Gut microbiota as a key regulator in endometriosis: mechanisms, therapeutic opportunities, and future perspectives (2026) · Frontiers in Cellular and Infection Microbiology · cited 5× · doi

  Xiaojun Liu 1†, Minghui Fan 1†, Yang Wang 2, Dongyun He 1* and Li Liu 1* 1Reproductive Medicine Center, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China, 2Department of Dermatology, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China Endometriosis (EMs), a common and frequently occurring gynecological disease, is a major cause of chronic pelvic pain and infertility in women. Its pathogenesis remains unclear to date, and it is characterized by high invasiveness and recurrence tendency. Although the specific pathogenesis of EMs has not been clarified, existing studies have confirmed that gut microbiota dysbiosis plays an important role in its pathogenic process. Studies suggest that gut microbiota may affect the occurrence and progression of EMs through immunoinflammatory pathways and metabolic pathways (such as enhanced estrogen metabolism and abnormal lipid metabolism). Meanwhile, approaches including dietary intervention, supplementation of probiotics or prebiotics, and microbiota transplantation can help prevent and alleviate EMs symptoms, providing potential therapeutic methods. This article will review the research progress on the correlation between gut microbiota dysbiosis and EMs, with the aim of offering more references for the diagnosis and treatment of EMs. KEYWORDS endometriosis, estrogen metabolism, gut microbiota, inflammation, probiotics

  generalfuture work
  Keywords: microbiota china jilin changchun metabolism medicine hospital university endometriosis pathogenesis dysbiosis pathways estrogen probiotics xiaojun

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