Extracellular vesicles (EVs) including exosomes, are small membrane vesicles derived from multivesicular bodies or from the plasma membrane. Most, if not all, cell types release EVs that then enter the bodily fluids. These vesicles contain a subset of proteins, lipids and nucleic acids that are derived from the parent cell. It is postulated that EVs have important roles in intercellular communication, both locally and systemically, by transferring their contents, including protein, lipids and RNAs, between cells. EVs are involved in numerous physiological processes, and vesicles from both non-immune and immune cells have important roles in immune regulation. Moreover, EV-based therapeutics are being developed and tested clinically for treatment of inflammatory and autoimmune diseases and cancer. Given the tremendous therapeutic potential of EVs this review focuses on the role of EVs in modulating immune responses and the therapeutic applications.

Dendritic cells (DCs) are the most potent APCs. Whereas immature DCs downregulate T-cell responses to induce/ maintain immunologic tolerance, mature DCs promote immunity. To amplify their functions, DCs communicate with neighboring DCs through soluble mediators, cell-to-cell contact, and vesicle exchange. Transfer of nanovesicles (< 100 nm) derived from the endocytic pathway (termed exosomes) represents a novel mechanism of DC-to-DC communication. The facts that exosomes contain exosomeshuttle miRNAs and DC functions can be regulated by exogenous miRNAs, suggest that DC-to-DC interactions could be mediated through exosome-shuttle miRNAs, a hypothesis that remains to be tested. Importantly, the mechanism of transfer of exosome-shuttle miRNAs from the exosome lumen to the cytosol of target cells is unknown. Here, we demonstrate that DCs release exosomes with different miRNAs depending on the maturation of the DCs. By visualizing spontaneous transfer of exosomes between DCs, we demonstrate that exosomes fused with the target DCs, the latter followed by release of the exosome content into the DC cytosol. Importantly, exosome-shuttle miRNAs are functional, because they repress target mRNAs of acceptor DCs. IntroductionCellular miRNAs are released membrane free 1 or packaged inside microvesicles (0.1-1 m) shed by the plasma membrane 2,3 or within nanovesicles (Ͻ 100nm) derived from the endocytic pathway known as exosomes. 4,5 Exosomes are generated as intraluminal vesicles by reverse budding of the membrane of multivesicular bodies (MVBs). Release of exosomes occurs when MVBs fuse their limiting membrane with the plasma membrane. [6][7][8][9] Dendritic cells (DCs) are APCs with the ability to regulate adaptive immunity. Whereas immature DCs down-regulate T-cell responses, mature DCs promote activation, proliferation, and differentiation of effector T cells. 10 Communication between DCs is essential to amplify their tolerogenic and immunogenic functions. 11,12 This DC-to-DC interaction is mediated through cell-tocell contact, soluble mediators, exchange of plasma membrane patches, 13,14 nanotubules, 15 and interaction with apoptotic cellderived vesicles 16 and exosomes. 17,18 Although the mechanisms have not been elucidated, it has been reported that DCs acquire proteins/peptides from other cells via exosomes. [17][18][19] Recently, it has been suggested that transfer of exosome-shuttle miRNAs might constitute a mechanism of cell-tocell communication that regulates mRNA translation 20 or, alternatively, a way to dispose of "unwanted" miRNAs. 21 An important unanswered question in the field is how exosome-shuttle miRNAs, transported inside the vesicles, are delivered into the cytosol of the acceptor cells, a problem we have investigated in this study with the use of DCs. Addressing this point has been challenging because (1) the composition of DC exosomes depends on the maturation of the DC of origin 22,23 ; (2) there is limited information on intercellular communication via "endogenous" (instead of exogenously added...

IntroductionDendritic cells (DCs) are antigen (Ag)-presenting cells (APCs) that function as biosensors of the cellular microenvironment by detecting the presence of signals that determine T-cell tolerance or immunity. 1,2 To accomplish this task, DCs acquire extracellular Ags by receptor-mediated endocytosis, macropinocytosis, or phagocytosis [3][4][5] ; by incorporation of microvesicles shed from the surface of neighboring cells, 6,7 and by their recently described interaction with nanovesicles (Յ 100 nm) termed "exosomes." [8][9][10][11][12] Exosomes are formed by reverse budding of the membrane of late endosomes [13][14][15] or multivesicular bodies (MVBs) and are released to the extracellular space by fusion of MVB with the plasma membrane. [13][14][15] Originally described in neoplastic cell lines, 16 exosomes also are produced by leukocytes and epithelial cells. [17][18][19][20][21][22] Although the function of exosomes still is poorly understood, exosomes are a source of Ag for APCs and participate in Ag presentation to T lymphocytes. 11,12 High concentrations of exosomes expressing major histocompatibility complex (MHC) and costimulatory molecules activate T-cell clones and T-cell lines weakly 10,13 and fail to stimulate naive T cells. 9,11 This impaired naive T-cell stimulatory ability of exosomes has been attributed to their low T-cell receptor-cross-linking capacity (inadequate for naive T-cell activation) and their small size and membrane composition. 10 However, in the presence of DCs, exosomes increase their ability to stimulate T cells. 10,11,23,24 The mechanism of interaction of extracellular exosomes with DCs is unknown. Although there is evidence that exosomes may transfer functional MHC-I/peptide complexes to DCs, 24 it is unclear whether exosomes cluster or fuse with DCs or if they are internalized and processed, as occurs with vesicles derived from apoptotic cells. [2][3][4][5] Herein we demonstrate that exosomes are internalized efficiently by DCs. Targeting of exosomes to DCs depends on ligands on the exosome and DC surface and is independent of complement factors. Once internalized by DCs, exosomes are sorted into recycling endosomes and then through late endosomes/lysosomes. By this mechanism, DCs process and present peptides derived from the internalized exosomes to T cells. In vivo, blood-borne exosomes are captured by DCs and specialized phagocytes of the spleen and by hepatic Kupffer cells. In the steady state, uptake of circulating exosomes by splenic DCs does not induce DC maturation and does not prevent CD40-induced DC activation in vivo. Our results demonstrate that blood-borne allogeneic exosomes are efficiently targeted, internalized, and processed by splenic DCs in vivo, a phenomenon followed by presentation of exosome-derived allopeptides by CD8␣ ϩ DCs to CD4 ϩ T cells. Since allogeneic exosomes are a rich source of alloMHC and are targeted and processed in vivo by host DCs (without inducing their activation), intravenous administration of donor-derived exosomes may constitut...

In recent years, there has been a shift from the perception of dendritic cells (DCs) solely as inducers of immune reactivity to the view that these cells are crucial regulators of immunity, which includes their ability to induce and maintain tolerance. Advances in our understanding of the phenotypical and functional plasticity of DCs, and in our ability to manipulate their development and maturation in vitro and in vivo, has provided a basis for the therapeutic harnessing of their inherent tolerogenicity. In this Review, we integrate the available information on the role of DCs in the induction of tolerance, with a focus on transplantation.