Exosomes in Cardiovascular Disease: From Mechanism to Therapeutic Target

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. In recent decades, clinical research has made significant advances, resulting in improved survival and recovery rates for patients with CVD. Despite this progress, there is substantial residual CVD risk and an unmet need for better treatment. The complex and multifaceted pathophysiological mechanisms underlying the development of CVD pose a challenge for researchers seeking effective therapeutic interventions. Consequently, exosomes have emerged as a new focus for CVD research because their role as intercellular communicators gives them the potential to act as noninvasive diagnostic biomarkers and therapeutic nanocarriers. In the heart and vasculature, cell types such as cardiomyocytes, endothelial cells, vascular smooth muscle, cardiac fibroblasts, inflammatory cells, and resident stem cells are involved in cardiac homeostasis via the release of exosomes. Exosomes encapsulate cell-type specific miRNAs, and this miRNA content fluctuates in response to the pathophysiological setting of the heart, indicating that the pathways affected by these differentially expressed miRNAs may be targets for new treatments. This review discusses a number of miRNAs and the evidence that supports their clinical relevance in CVD. The latest technologies in applying exosomal vesicles as cargo delivery vehicles for gene therapy, tissue regeneration, and cell repair are described.

Unraveling the Intricate Roles of Exosomes in Cardiovascular Diseases: A Comprehensive Review of Physiological Significance and Pathological Implications

“…Recently, exosomes, which are naturally released by mammalian cells, have emerged as pivotal tools for intercellular cardiac communication [22][23][24], significantly influencing vascular integrity and CVD [25,26]. Functioning as cargo carriers, exosomes encapsulate complex substances [27], with cargo composition varying according to the originating cell type and its "health status". Consequently, exosomes yield disparate functional outcomes upon incorporation into recipient cells.…”

Research hotspots and emerging trends of mesenchymal stem cells in cardiovascular diseases: a bibliometric-based visual analysis

“…They have long been a focal point in clinical research for treating CVDs ( 137 ). The therapeutic effects of MSCs on various CVDs, including myocardial infarction, atherosclerosis, pulmonary hypertension, and so on, have been extensively investigated ( 22 , 56 , 138 – 141 ). The immense potential of MSCs in various applications remains undeniable in the future.…”

“…The immense potential of MSCs in various applications remains undeniable in the future. However, recent research on MSCs may have reached a plateau, and the problems of low survival after transplantation and low differentiation efficiency still need to be solved ( 138 , 142 ). What’s more, low retention, weak homing activity, invasive isolation process, and limited tissue volume obtained are also the key issues that limit the application of MSCs in the clinic ( Figure 10 ) ( 143 – 145 ).…”

Unraveling the Multifaceted Roles of Extracellular Vesicles: Insights into Biology, Pharmacology, and Pharmaceutical Applications for Drug Delivery

“…2.4.6. Cardiovascular System (Blood Pressure and Coagulation) EVs have been shown to participate in the pathogenesis of different cardiovascular diseases (CVDs) [196][197][198]. Direct contact between blood vessel endothelial cells and peripheral blood allows endothelial cell (EC)-EVs to be rapidly released and delivered to distant organs, thus influencing the onset of different CVDs.…”