Extracellular vesicles (EVs) are membrane-derived lipid bilayers secreted by bacteria and eukaryotic cells. Bacterial membrane vesicles were discovered over 60 years ago and have been extensively studied in Gram-negative bacteria. During their production, EVs are loaded with proteins, nucleic acids, and various compounds that are subsequently released into the environment. Depending on the packaged cargo, EVs have a broad spectrum of action and are involved in pathogenesis, antibiotic resistance, nutrient uptake and nucleic acid transfer. Due to differences in cell wall structure, EVs from Gram-positive bacteria have been disregarded for decades, and our understanding of biogenesis and host cell interaction is incomplete. Recently, studies on bacteria such as Staphylococcus aureus, Streptococcus sp., Bacillus subtilis and Mycobacterium sp., have demonstrated EV production in Gram-positive bacteria and shown the great importance EVs play in Gram-positive bacterial physiology and disease progression. Here we review the latest findings on the biogenesis and functions of EVs from Gram-positive bacteria and identify key areas for future research.
Our findings suggest that appropriate medication and illness beliefs coupled with a stable medication routine are helpful in achieving optimal medication adherence in stroke patients. Interventions designed to target both intentional and non-intentional adherence may help maximize medication adherence in stroke patients.
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