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Co-culturing ESCs with monocyte-derived macrophages and NK cells from endometriosis patients showed that the interaction between ESCs and macrophages downregulates NK cell cytotoxicity by enhancing the release of IL-10 and TNF- (37), potentially allowing endometrial fragments to evade immune clearance (38)

Dormancy is further stabilized by intrinsic regulators such as lncRNA NR2F1-AS1, which regulates stemness to prevent metastatic activation, and laminin-211 from the astrocytes in the brain, which maintains quiescence through dystroglycan signaling (163)

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Beyond its initial description as a growth hormone (GH) secretagogue stimulator of appetite, ghrelin has been revealed to have a wide range of physiological effects, for example, the modulation of inflammation