Potential Markers of Endometriosis: Latest Update

Endometriosis is a complicated chronic disease that is characterized by the presence of ectopic lesions commonly located in the ovaries, peritoneum, and rectovaginal septum. It can cause irregular bleeding, pain, and infertility in the millions of affected women globally. While it is associated with abnormal mechanisms of retrograde menstruation, inflammation, and oxidative stress, but its etio-pathogenesis is not clearly characterized. Previous and recent literature supports the presence of altered levels of immunological signaling molecules growth factors, oxidants, and antioxidants in patients with endometriosis. This article reviews such literature regarding these biomarkers in four biological windows: serum, peritoneal fluid, follicular fluid, and relevant endometrial tissue samples. The investigation of changes in the proteome expression and oxidative stress markers in endometriosis has been shown to reflect the presence and severity of the condition, suggesting these molecules may possess the relevance and capability to function as early diagnostic markers. Current standard of laparoscopic diagnosis can delay detection by approximately nine years; therefore, establishing a non-invasive, inexpensive diagnostic methodology could simplify detection, reduce the use of invasive procedures, improve management, and address worldwide public health concerns. Characterization of multiple highly specific and sensitive biomarkers is necessary to create a reliable testing panel for early detection of endometriosis. The focus of the review is to summarize the relevant biomarkers as potential diagnostic tools for endometriosis and understand the roles of immunological and chemical modulators in this pathology. Our review also suggests that future research direction regarding diagnostic potential of biomarkers should further showcase reproducible results to establish the credibility of associated molecules.