Nanomaterials for endometriosis: a multimodal strategy integrating targeted delivery, immunomodulation, and physical ablation

Endometriosis is a chronic inflammatory condition for which existing treatments, mainly hormonal therapy and surgical intervention, remain insufficient. These approaches are often limited by high recurrence rates, significant side effects, and an inability to effectively target underlying disease mechanisms. This review outlines emerging mechanism-oriented therapeutic strategies that combine targeted drug delivery, immunomodulation, and physical ablation. Advanced delivery systems, such as Lipid nanoparticle polymeric carriers, and nanomicelles, enable selective accumulation of therapeutic agents at endometriotic lesions, improving efficacy while minimizing systemic toxicity. Immunomodulatory strategies pursue to re-establish immune balance by enhancing immune surveillance, driving macrophage polarization toward anti-inflammatory states, and suppressing pro-inflammatory signaling, often through nanocarrier-enabled localized delivery. Furthermore, physical ablation techniques including gold (Au) NPs-mediated photothermal therapy and magnetic hyperthermia offer minimally invasive approaches for precise lesion elimination while preserving adjacent healthy tissues. Collectively, integrating these strategies may advance preclinical efforts to improve disease management, patient stratification, and potentially fertility outcomes, although clinical validation is still required. Despite ongoing challenges in clinical translation, the convergence of nanotechnology, immunology and interventional therapy marks a conceptual shift away from symptom-centered management toward investigational strategies that, pending clinical validation, may confer disease-modifying potential in endometriosis.