Exosomes in heart disease and therapy

Exosomes are nanoscale membrane-bound extracellular vesicles secreted by most eukaryotic cells in the body that facilitates intercellular communication. Exosomes carry several signaling biomolecules, including miRNA, proteins, enzymes, cell surface receptors, growth factors, cytokines and lipids that can modulate target cell biology and function. Due to these capabilities, exosomes have emerged as novel intercellular signaling mediators in both homeostasis and pathophysiological conditions. Recent studies document that exosomes (both circulating or released from heart tissue) have been actively involved in cardiac remodeling in response to stressors. Also, exosomes released from progenitor/stem cells have protective effects in heart diseases and shown to have regenerative potential in the heart. Researchers from the University of Alabama at Birmingham discuss the critical role played by circulating exosomes released from various tissues and from cells within the heart in cardiac health; the gap in knowledge that needs to be addressed to promote future research; and exploitation of recent advances in exosome engineering to develop novel therapy.

The complex role of cardiac and non-cardiac derived exosomes in cardiac pathophysiology

(A) Exosomes from different organs affect the pathophysiology of the heart through the delivery of signaling molecules, micro-RNA and enzymes. However, the role of exosomes derived from the liver, lung, muscle, nervous system, metabolic co-morbidities, and exercise that can affect heart health are yet to be determined. (B) Exosomes from different cell types within the heart can program cells within the heart to promote cardiac remodeling that affect heart structure and function. (C) Under Diabetic milieu, exosomes from different cell types within the heart can bring about coronary endothelial dysfunction, cardiac hypertrophy, and cardiac fibrosis.