Recent Advances in the Use of Exosomes in Sjögren’s Syndrome

Abstract

Sjögren’s syndrome (SS) is a chronic autoimmune disorder of the exocrine glands mediated by lymphocytic infiltrates damaging the body tissues and affecting the life quality of patients. Although traditional methods of diagnosis and treatment for SS are effective, in the time of personalized medicine, new biomarkers, and novel approaches are required for the detection and treatment of SS. Exosomes represent an emerging field in the discovery of biomarkers and the management of SS. Exosomes, a subtype of extracellular vesicles, are secreted by various cell types and can be found in most bodily fluids. Exosomes are packed with cytokines and other proteins, bioactive lipids, and nucleic acids (mRNA, circular RNA, non-coding RNA, tRNA, microRNA, genomic DNA, and ssDNA), and transport such cargo between cells. Evidence has indicated that exosomes may play roles in processes such as the modulation of the immune response and activation of inflammation. Moreover, due to features such as stability, low immunogenicity and toxicity, long half-life, and the capacity to penetrate the blood-brain barrier, exosomes have also emerged as therapeutic tools for SS. In this review, we summarize existing literature regarding the biogenesis, isolation, and function of exosomes, specifically focusing on exosomes as novel biomarkers and their potential therapeutic uses in SS.

Potential Use of Exosomes as Diagnostic Biomarkers and in Targeted Drug Delivery: Progress in Clinical and Preclinical Applications

“…191 , 192 Multiple previously published reviews and research articles conclude that exosomes released from immune cells play both preventive and developmental roles in autoimmune diseases. 193 , 194 Mesenchymal stromal cell (MSC) exosomal immune properties are well studied. Zhang et al showed that MSC-derived exosomes induced production of CD4 + CD25 + Foxp3 + Treg or CD4 + CD25 + T-cells via allogeneic APC-enriched CD11C + cells through T-cell activation.…”

The Emerging Role of Topical Ocular Drugs to Target the Posterior Eye

“…Immunologically active exosomes have been found to regulate innate and adaptive immune responses [165]. Thus, EVs can naturally be a part of the regimen for many ocular inflammatory conditions [166][167][168][169].…”

Mini Review: Current Trends and Understanding of Exosome Therapeutic Potential in Corneal Diseases

“…Sjögren’s syndrome is a chronic autoimmune disorder characterized by lymphocytic infiltration in the lacrimal and salivary glands, leading to eye and oral dryness. The exocrinopathy can result from primary Sjögren’s syndrome (pSS) or it can be secondary to other autoimmune disorders such as systemic lupus erythromatosus (SLE) or rheumatoid arthritis ( Huang et al, 2020 ). The pathogenesis of Sjögren’s syndrome involves activation of both innate and adaptive immune pathways, e.g., B cell-activating factor (BAFF)/BAFF receptor axis, interferon (IFN) signatures, and nuclear factor kappa B (NF-kB) signaling ( Sandhya et al, 2017 ).…”

“…The pathogenesis of Sjögren’s syndrome involves activation of both innate and adaptive immune pathways, e.g., B cell-activating factor (BAFF)/BAFF receptor axis, interferon (IFN) signatures, and nuclear factor kappa B (NF-kB) signaling ( Sandhya et al, 2017 ). Prognostic markers for Sjögren’s syndrome include anti-Ro/SSA, anti-La/SSB, and antinuclear autoantibodies (ANA) ( Huang et al, 2020 ). These autoantigens are released by salivary gland epithelial cells via exosomes.…”

“…Thus, MSC-Exos show therapeutic effects for Sjögren’s syndrome-induced dry eyes. MSC-Exos execute their modulatory effects on the polarization of lacrimal macrophage and through the enhancement of Th2 and Treg responses via targeting of NF-kB signaling ( Li et al, 2019a ; Huang et al, 2020 ).…”