Vet Med - Czech, 2026, 71(2):62-72

The inhibition of deep peritoneal endometriosis by Andrographolide through macrophage M1 activity in an endometriosis mice modelOriginal Paper

IA Susianto ORCID...^1,2,3, N Susilaningsih^1,4, ST Hidayat ORCID...^1,5, Hardian ORCID...^1,6, RR Tjandrawinata ORCID...⁷, B Rachmawati ORCID...^1,8

¹ Doctoral Research Degree, Medical Faculty, Diponegoro University, Semarang, Indonesia

² Obstetric Gynecology Department, Anugerah Women and Children Hospital, Semarang, Indonesia

³ Obstetric Gynecology Department, Medical Faculty, Soegijapranta Catholic University, Semarang, Indonesia

⁴ Anatomy Histology Department, Medical Faculty, Diponegoro University, Semarang, Indonesia

⁵ Obstetric Gynecology Department, Medical Faculty, Diponegoro University, Semarang, Indonesia

⁶ Physiology Department, Medical Faculty, Diponegoro University, Semarang, Indonesia

⁷ Biotechnology Department, Atma Jaya Catholic University, Banten, Indonesia

⁸ Endocrinology and Clinical Pathology Department, Medical Faculty, Diponegoro University, Semarang, Indonesia

This study aims to demonstrate that Andrographolide, an herbal immunostimulant, can influence M1 macrophages to inhibit inflammation, including the growth of endometriosis caused by inflammation. This study evaluates the effects of Andrographolide on suppressing endometriosis through M1 macrophage activity. This post-test-only experimental study involved 42 female Balb/C mice, which were divided into six groups: Group N, KN (endometriosis without therapy), and KP (endometriosis + dienogest), P1 (endometriosis with 0.05 mg/kg), P2 (endometriosis + 0.1 mg/kg Andrographolide), and P3 (endometriosis + 0.2 mg/kg Andrographolide). Peritoneal fluid was aspirated, and the peritoneum was cut and stretched to observe the extent of the endometriosis. This study compared the formation of ectopic endometrial lesions and analysed the M1/M2 ratio in each group that received standard therapy versus Andrographolide therapy. The results from peritoneal fluid flow cytometry indicated that M1 was more dominant than M2 compared with KP. The levels of M2 in the P2 and P3 groups were also significantly lower than in the KN group. This study demonstrated that Andrographolide may enhance the regulation of M1 macrophage differentiation, acting as a precursor to endometriosis growth by suppressing M2 phenotypes that promote the condition.

Keywords: Andrographis paniculata; endometriosis; immunomodulator; peritoneal macrophage

Received: April 24, 2025; Revised: November 10, 2025; Accepted: November 12, 2025; Published: February 27, 2026  Show citation