Charting the nerve–immune axis in endometriosis

Endometriosis is increasingly recognized as a systemic disorder involving complex interactions between nerves and immune cells, driving chronic pain and inflammation beyond the initial theories. Recent breakthroughs highlight aberrant sensory nerve growth and dysfunctional immune responses as key events in lesion development and sustained pain. This review systematically examines the functional link between neuroimmune interplay and endometriosis, showing how reciprocal signaling between nerves and immune cells actively shapes epithelial and stromal behavior, amplifies inflammation, and reinforces pain circuitry. Recognizing this integrated neuroimmune framework reframes endometriosis as a disorder of distributed network dysregulation and highlights that targeting key neuroimmune nodes may offer new therapeutic opportunities to curb both lesion progression and endometriosis-related chronic pain.