“…Several studies have evaluated the concentrations and origins of circulating EVs in the maternal system and elucidated their ability to interact with the immune cells and regulate them [28,57,71,82]. Remarkably, pregnancy is characterized by higher levels of circulating EVs than non-pregnant state and they progressively increase with gestational age, achieving highest concentration in the third trimester [65,71,79]. During early stages of pregnancy, EVs derived from endometrium, embryo, and trophoblast cells can influence the maternal immune response, whereas towards the advanced stages of gestation, the EVs released by the placenta, mainly STB-derived EVs, are the key players (reviewed in [94]).…”