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. 2023 Aug 22;14:1223828. doi: 10.3389/fimmu.2023.1223828

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Copyright © 2023 Abbaszadeh, Karimi and Rajaei

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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Local and systemic alteration of immunity is an outstanding feature of EMS pathogenicity. Macrophages have dual functions in tissue injury and repair. M1 by the secretion of proinflammatory mediators (TNF-α, IL-6, and IL-1) and M2 by the secretion of anti-inflammatory cytokines (IL-4, IL10, and IL-13) have been suggested to inhibit and promote the development of endometriosis, respectively. TH17 is a subset of differentiated T cells that has remarkably increased in number. These cells can secrete IL-17A having a synergistic effect with TNF-α in terms of inflammation. One further change in immunity is low-level NK cells’ cytotoxicity against ESCs due to the upregulation of inhibitory receptors like KIR2DL1.