Exploring extracellular vesicles as mediators of clinical disease and vehicles for viral therapeutics: Insights from the COVID-19 pandemic

Abstract

The COVID-19 pandemic has challenged researchers to rapidly understand the capabilities of the SARS-CoV-2 virus and investigate potential therapeutics for SARS-CoV-2 infection. COVID-19 has been associated with devastating lung and cardiac injury, profound inflammation, and a heightened coagulopathic state, which may, in part, be driven by cellular crosstalk facilitated by extracellular vesicles (EVs). In recent years, EVs have emerged as important biomarkers of disease, and while extracellular vesicles may contribute to the spread of COVID-19 infection from one cell to the next, they also may be engineered to play a protective or therapeutic role as decoys or “delivery drivers” for therapeutic agents. This review explores these roles and areas for future study.

COVID-19 and Long COVID: Disruption of the Neurovascular Unit, Blood-Brain Barrier, and Tight Junctions

“…Exosomes can cross the BBB, which could be implicated in the pathogenesis of disease mechanisms (Guedes and others 2020). Extracellular vehicles could spread COVID-19 from one cell to another and may be used for the delivery of therapeutic agents, including for brain delivery (Craddock and others 2022; Kodidela and others 2022). Moreover, it has been reported that exosomes from patients with ME/CFS activate human microglia (SV40 cell line) in vitro to release IL-1β, indicating a new therapeutic option for ME/CFS (Tsilioni and others 2022).…”