How does endometriosis or adenomyosis know where to grow? I understand that scientists have multiple theories regarding the initial occurrence of endometriosis; however, how does the endometriosis know where to grow? For example, how does it spread/move to the eyes, brain etc.
Endometriosis
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College is challenging enough when you’re healthy – throw endometriosis into the mix, and it can feel downright impossible some days. Classes, exams, and the
December 23, 2024
To the best of our current understanding, although they are highly related, adenomyosis remains confined to the uterine myometrium, whereas endometriosis has the potential to disseminate to distant anatomical sites. The precise mechanisms by which endometriosis spreads and establishes itself in remote organs remain incompletely understood, but are likely multifactorial. These mechanisms likely differ between individuals and involve both routes of dissemination—including direct extension within the peritoneal cavity, lymphatic spread, or hematogenous (blood-borne) transmission—and systemic failures in genetic, molecular, and immunologic regulation.
In particular, impaired immune surveillance may allow ectopic endometriosis cells to evade clearance, while pathological angiogenesis facilitates the development of an aberrant blood supply that supports their growth and survival in ectopic locations.
Additionally, the embryologic (Müllerianosis) theory suggests that misplaced Müllerian-derived cells during fetal development may later give rise to endometriosis in distant sites.
Ultimately, while endometriosis cells do not “know” where to grow, they appear to exploit weaknesses in immune defense, vascular and lymphatic transport systems, and tissue microenvironments that are permissive to implantation and growth.