The Involvement of Exosomes in Glioblastoma Development, Diagnosis, Prognosis, and Treatment

Abstract

Brain tumours are a serious concern among both physicians and patients. The most feared brain tumour is glioblastoma (GBM) due to its heterogeneous histology, substantial invasive capacity, and rapid postsurgical recurrence. Even in cases of early management consisting of surgery, chemo-, and radiotherapy, the prognosis is still poor, with an extremely short survival period. Consequently, researchers are trying to better understand the underlying pathways involved in GBM development in order to establish a more personalised approach. The latest focus is on molecular characterisation of the tumour, including analysis of extracellular vesicles (EVs), nanostructures derived from both normal and pathological cells that have an important role in intercellular communication due to the various molecules they carry. There are two types of EV based on their biogenesis, but exosomes are of particular interest in GBM. Recent studies have demonstrated that GBM cells release numerous exosomes whose cargo provides them the capacity to facilitate tumour cell invasion and migration, to stimulate malignant transformation of previously normal cells, to increase immune tolerance towards the tumour, to induce resistance to chemotherapy, and to enhance the GBM vascular supply. As exosomes are specific to their parental cells, their isolation would allow a deeper perspective on GBM pathogenesis. A new era of molecular manipulation has emerged, and exosomes are rapidly proving their value not only as diagnostic and prognostic markers, but also as tools in therapies specifically targeting GBM cells. Nonetheless, further research will be required before exosomes could be used in clinical practice. This review aims to describe the structural and functional characteristics of exosomes and their involvement in GBM development, diagnosis, prognosis and treatment.

Role of Exosomes in the Progression, Diagnosis, and Treatment of Gliomas

“…The GSC-derived exosome-mediated miRNA transport facilitates the proliferation of epithelial and glioma cells [ 39 ]. Further, exosomes secreted by the GSCs mediate the dedifferentiation of non-GSC glioma cells into GSCs via the Notch signaling pathway, and enhance the stemness and tumorigenicity of non-GSC glioma cells [ 29 , 38 ].…”

“…The GDEs are a better diagnostic sample than other currently used samples (urine or serum) because of the specificity and sensitivity of detection. The type, origin, differentiation, and genotype of a malignant glioma can be determined by studying exosome profiles and predicting the therapeutic response and prognosis [ 38 ]. Furthermore, exosomal cargo (mRNAs, miRNAs, proteins, and DNA) has helped identify potentially important biomarkers applicable in clinical diagnosis.…”

Effects of Surgery on the 30-Day Survival Rate in Spontaneous Supratentorial Intracerebral Hemorrhage

“…Exosomes, as circulating vesicles, have the role of transporting molecules specific to the cells of origin. These molecules are involved in cell regeneration, immune response, and new vascular supply by angiogenesis [ 34 ]. Exosomes from mesenchymal stem cells seem to play an essential role in the process of neuroregeneration, especially after hemorrhagic stroke [ 35 , 36 ].…”

Biosensors-on-Chip: An Up-to-Date Review

“…Recent years have witnessed an increasing number of studies regarding the identification of neurodegeneration-related biomarkers [ 110 , 111 , 112 ]. In this regard, various biomarkers including amyloid-β peptides, tau proteins, neurofilament light, for neuronal injury, neurogranin, BACE1, SNAP-25, and synaptotagmin for synaptic dysfunction and/or loss, sTREM2, YKL-40, interleukins, tumor necrosis factor α, and lactoferrin for neuroinflammation due to the activation of microglia and astrocytes, and clusterin for apoptosis [ 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 ]. There are many studies investigating the efficiency of biosensors for the identification of these biomarkers [ 133 , 134 ].…”