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. 2023 Apr 3;5:1130849. doi: 10.3389/frph.2023.1130849

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© 2023 Wang, Dragovic, Greaves, Becker and Southcombe.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The chemokine-mediated intercellular communication of macrophages and other cells in the peritoneal microenvironment of endometriosis. Ectopic endometriotic lesions in the peritoneal cavity are composed of stromal cells and epithelial cells and infiltrated with blood vessels and nerve fibres. In the surrounding peritoneal fluid (PF), immune cells are present, including macrophages, neutrophils, T cells and B cells. The number of total peritoneal macrophages and CD206⁺/CD163⁺ macrophages are increased in PF of endometriosis patients. Stromal cells from the endometriotic lesions, mesothelial cells from peritoneum, nerve fibres attract macrophages to peritoneal cavity via the secretion of attractant factors like monocyte chemoattractant protein-1 (MCP-1/CCL2), colony-stimulating factor-1 (CSF-1), and RANTES (CCL5). Existing peritoneal macrophages also secrete MCP-1 to attract more macrophages. Treg cells induce macrophage polarisation into pro-repair subtypes via the secretion of soluble fibrinogen-like protein 2 (sFGL2), favouring lesion growth. On the other hand, peritoneal macrophages facilitate lesion growth, angiogenesis, neurogenesis and Treg differentiation via the secretion of cytokines and growth factors including interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-12 (IL-12), tumour necrosis factor alpha (TNF-α), vascular epithelial growth factor (VEGF) and transforming growth factor beta 1 (TGF-β1). (Created with biorender.com).