Recent Progress of Exosomes in Multiple Myeloma: Pathogenesis, Diagnosis, Prognosis and Therapeutic Strategies

Abstract

Multiple myeloma (MM) is a hematological malignancy that is still incurable. The bone marrow microenvironment (BMM), with cellular and non-cellular components, can create a favorable environment for the survival, proliferation and migration of MM cells, which is the main reason for the failure of MM therapies. Many studies have demonstrated that exosomes play an important role in the tumor-supportive BMM. Exosomes are nanoscale vesicles that can be released by various cells. Some exosomes contribute to the pathogenesis and progression of MM. MM-derived exosomes act on different cells in the BMM, thereby creating an environment conducive to the survival and growth of MM cells. Owing to the important roles of exosomes in the BMM, targeting the secretion of exosomes may become an effective therapeutic strategy for MM. In addition, the abnormal expression of “cargos” in the exosomes of MM patients may be used to diagnose MM or used as part of a screen for the early prognoses of MM patients. Exosomes also have good biological properties, including safety, biocompatibility, stability and biodegradability. Therefore, the encapsulation of anti-cancer drugs in exosomes, along with surface modifications of exosomes with targeting molecules, are very promising strategies for cancer therapies—particularly for MM. In addition, DC-derived exosomes (DC-EXs) can express MHC-I, MHC-II and T cell costimulatory molecules. Therefore, DC-EXs may be used as a nanocarrier to deliver cancer vaccines in MM. This review summarizes the recent progress of exosome research regarding the pathogenesis of, diagnosis of, prognosis of and therapeutic strategies for MM.

Recent Advances in Exosome-Based Drug Delivery for Cancer Therapy

“…The composition of exosomes can represent the biological state of the cells from which they are derived and has been implicated in the physiological and pathological processes of various diseases. In particular, it is known to play an important role in the pathogenesis of cancer, including the communication between multiple cells such as cancer cells and immune cells [4,5].…”

Mesenchymal Stem Cell-Derived Exosomes as a Novel Strategy for the Treatment of Intervertebral Disc Degeneration

“…The quantity and quality of exosomes obtained are susceptible to uncertainties due to external factors. Further, it is difficult to separate other impurities of similar density, such as vesicles and proteins, from the obtained exosomes ( Wang et al, 2021 ).…”

Role of Extracellular Vesicle-Based Cell-to-Cell Communication in Multiple Myeloma Progression

“…However, ongoing studies are investigating the possibility of encapsulating chemotherapeutic agents, e.g., doxorubicin, to ensure more specific drug delivery to tumor cells without side effects [123]. This strategy could be used for various anti-MM drugs, including monoclonal antibodies (e.g., anti-CD38, anti-SLAMF7 mAbs) to improve their efficacy [124]. Synthetic nanoparticles formulation has been developed for miRs delivery.…”