Precision-based solutions for endometriosis: Integrating immunomics and drug repositioning strategies

Endometriosis (EMs) is an estrogen-dependent, chronic inflammatory disorder characterized by immune microenvironment dysregulation, a critical factor in its pathogenesis. Despite existing therapies, limitations persist, highlighting the urgent need for innovative treatment strategies. This review explores the roles of immune cell dysfunction, immune evasion, and immunomics in EMs. We emphasize the potential of immune-modulating therapies, anti-inflammatory agents, targeted interventions, and epigenetic modulators in advancing treatment options. Additionally, we propose a drug screening framework based on the immune microenvironment. Integrating these insights with drug repositioning approaches promises to drive EMs therapy toward more tailored, precision-based solutions.