The Comorbidity of Endometriosis and Systemic Lupus Erythematosus: A Systematic Review

Researched by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Fact-checked by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

March 18, 2025

  • Women’s Health
    Women’s Health

    Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.

  • Endometriosis
    Endometriosis

    Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

  • Autoimmune Diseases
    Autoimmune Diseases

    Autoimmune disease is when the immune system mistakenly attacks the body's tissues, often linked to imbalances in the microbiome, which can disrupt immune regulation and contribute to disease development.

Researched by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Fact-checked by:

  • Karen Pendergrass ID
    Karen Pendergrass

    User avatarKaren Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

Last Updated: 2024

Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.

Karen Pendergrass

Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.

DOI: 10.7759/cureus.42362

What Was Reviewed?

This systematic review examined the comorbidity between endometriosis and systemic lupus erythematosus (SLE), two chronic conditions with significant implications for women’s health. The review aimed to elucidate the prevalence, shared pathophysiological mechanisms, and risk factors linking these diseases, emphasizing immune dysregulation, genetic predispositions, and hormonal influences. The review synthesized findings from nine studies conducted between 2011 and 2021, including case-control, cohort, and systematic review methodologies.

Who Was Reviewed?

The review focused on studies of females aged 12-60, representing the pubertal to postmenopausal age range. The population comprised patients with diagnosed endometriosis and SLE. The studies predominantly included participants from diverse ethnicities and geographies, screened based on standardized inclusion criteria to establish the prevalence and interaction of these conditions.

What Were the Most Important Findings?

The review confirmed a statistically significant correlation between endometriosis and SLE, with women diagnosed with either condition at a heightened risk of developing the other. The findings implicated immune dysregulation, characterized by diminished cytotoxic T-cell activity and elevated humoral immune responses, as a central mechanism. Notable microbial associations include increased systemic inflammation mediated by cytokines such as interleukin-1, interleukin-6, and tumor necrosis factor (TNF-α). Genetic factors also played a role, with gene loci such as PTPN22 associated with increased susceptibility to both conditions. Surgical interventions like hysterectomy were linked to increased inflammation and subsequent autoimmune activation, while modified surgical techniques showed promise in mitigating risk.

What Are the Greatest Implications of This Review?

This review highlights the necessity for clinicians to adopt an interdisciplinary approach when managing patients with either endometriosis or SLE, as their comorbidity exacerbates disease burden and complicates treatment. It emphasizes the importance of targeted therapies to modulate immune response alongside careful evaluation of surgical and hormonal treatment strategies to minimize adverse outcomes. The findings suggest a potential for incorporating microbial and genetic markers into diagnostic and therapeutic protocols to improve outcomes.

Endometriosis

Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

Endometriosis

Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.

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