Exosomes in Cardiovascular Medicine

Abstract

Exosomes are small, extracellular membrane-bound particles that mediate intercellular transport of a cytosolic cargo. Exosomal transfer of micro-RNA can modify gene expression in targeted cells. Exosome-based endocrine/paracrine signaling has been shown to be involved in a wide range of physiological processes including those associated with cardiovascular injury and disease, but remains relatively poorly understood. Exosomes offer great potential to the clinical field, with applications in both diagnostics and therapeutics. A stable, circulating form of micro-RNA exists in blood protected from endogenous nucleases. This population of micro-RNA, which includes both exosomal and non-exosomal fractions, may be isolated from blood and exploited as a novel disease biomarker with the potential to deliver increased specificity and rapid diagnosis compared to conventional biomarkers. Exosomes also offer a natural drug-delivery vehicle, providing immune evasion and specific targeting through engineering of surface-displayed ligands. Much of the cardioprotective and regenerative benefits of stem-cell grafts are now thought to derive from paracrine signaling rather than direct tissue incorporation and therefore stem cell-derived exosomes offer the potential for a convenient cell-free therapeutic option, eliminating many of the risks and variability associated with stem-cell therapy. In this review, we consider the potential applications of this emerging field to cardiovascular medicine, taking myocardial infarction as our primary example.

Circulating Exosomal SOCS2-AS1 Acts as a Novel Biomarker in Predicting the Diagnosis of Coronary Artery Disease

“…Currently, it has been recognized that circulating exosomes released from leukocytes, platelets, and endothelial cells, as regulators of CAD, could reflect the stage or progression of the disease [16]. It has also been proved that the changes of exosome contents including lncRNAs may be measured as potential diagnostic and prognostic biomarkers and therapeutic targets for CAD [13,14,17]. erefore, we aimed to determine whether or not certain circulating exosome-encapsulated lncRNAs could be as promising biomarkers for the diagnosis of CAD, especially in an early stage.…”

“…It has been shown that the changes of exosome contents including lncRNAs can lead to significant alterations in certain biological processes, which may play important roles in the development and progression of CAD. Furthermore, exosome contents also can be measured as potential diagnostic and prognostic biomarkers and therapeutic targets for CAD [13,14]. It was reported that exosomal lncRNA GAS5 could regulate the apoptosis of macrophages and vascular endothelial cells in atherosclerosis [15].…”

Novel Invasive and Noninvasive Cardiac-Specific Biomarkers in Obesity and Cardiovascular Diseases

“…Research on CVD with some exosome cargos (miRNAs, lipids, and proteins) provide the development of noninvasive discovery of novel biomarkers. 299,300,302,303 However, their clinical use remains juvenile. A study, utilizing genetically modified mice, shows the critical requirement for miRNAs in cardiac development, as mice deficient in Dicer experience cardiac failure.…”

“…306 Furthermore, treatment of miR-133a inhibitors reduces the level of cardiac hypertrophy. 306 The levels of miR-22, 99a, 214, and 21 increased expression or decreased expression of miR-15, 320, 132, 212, 652, 92a, and 34, which provides beneficial or protective effects in the treatment of CVD 299,302,303 (Fig. 8).…”

Stem Cell-Derived Exosome in Cardiovascular Diseases: Macro Roles of Micro Particles

“…Exosomes are critical cellular communicators between cells, which offer the clinical potential for both detection and treatment of various diseases. Noteworthy, exosomes are of great increasing interest for three major reasons with potential clinical applications in CVDs as following: (1) diagnostics and prognostic biomarkers, (2) therapeutic strategies, and (3) drug carriers (Dykes, 2017 ; Zhang et al, 2017 ).…”