Extracellular vesicles in atherothrombosis: From biomarkers and precision medicine to therapeutic targets

Abstract

Summary Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of global mortality. Extracellular vesicles (EVs) are small phospholipid vesicles that convey molecular bioactive cargoes and play essential roles in intercellular communication and, hence, a multifaceted role in health and disease. The present review offers a glimpse into the current state and up‐to‐date concepts on EV field. It also covers their association with several cardiovascular risk factors and ischemic conditions, being subclinical atherosclerosis of utmost relevance for prevention. Interestingly, we show that EVs hold promise as prognostic and diagnostic as well as predictive markers of ASCVD in the precision medicine era. We then report on the role of EVs in atherothrombosis, disentangling the mechanisms involved in the initiation, progression, and complication of atherosclerosis and showing their direct effect in the context of arterial thrombosis. Finally, their potential use for therapeutic intervention is highlighted.

Optimized operation of a controlled stirred tank reactor system for the production of mesenchymal stromal cells and their extracellular vesicles

“…More recently, most of the potential beneficial effects of MSC therapies have been primarily attributed to EVs, with several studies confirming that EVs recapitulate many of the features of their parental cell line (MSC). Overall, MSC-EVs have been being explored for the potential treatment of spinal cord injury (Wang et al, 2021), acute kidney injury (Bruno et al, 2012), atherosclerotic cardiovascular disease (Badimon et al, 2022), myocardial ischemia (Charles et al, 2020;Ma et al, 2017;Zhu et al, 2018), among other diseases. To support all these clinical applications, large doses of EVs will be required and the limited manufacture capacity of traditional static culture systems will be a major hurdle towards the implementation of EVs-based therapies.…”

Lipoprotein(a) in Atherosclerotic Diseases: From Pathophysiology to Diagnosis and Treatment

“…Moreover, emerging evidence highlights the role of extracellular vesicles in pathogenesis of atherosclerosis and atherothrombosis [ 102 , 103 , 104 ]. Platelet-derived exosomes have a pivotal role in hemostasis and thrombosis because of their interaction with several vascular cell types (i.e., endothelial cells, vascular smooth muscle cells) and intercellular communication [ 105 , 106 ].…”

Diagnosis potential of subarachnoid hemorrhage using miRNA signatures isolated from plasma-derived extracellular vesicles

“…Extracellular vesicles, including exosomes and microvesicles, are important mediators of intercellular communication and used as biomarkers for disease ( Badimon et al, 2022 ; Clancy and D'Souza-Schorey, 2022 ). In this study, we detected extracellular lipid vesicles of 30–150 nm in diameter, most of which consisted of exosomes, in plasma from patients with subarachnoid hemorrhage, and the subsequent analyses were primarily in exosomes.…”