The book provides an intensive overview of exosomes in cardiovascular diseases, their potential as biomarkers, as well as their pathological and therapeutic effects. Exosomes derived from various cell types can influence the heart by providing their cargo with RNA, DNA, lipids and proteins. Exosomal content can reach the heart through the bloodstream or directly through cell-to-cell contact and exert beneficial effects on apoptosis, fibrosis and angiogenesis. Extracellular vesicles play an important role in maintaining normal cardiac structure and function under physiological conditions and change their composition under pathological conditions to promote the development of cardiovascular diseases.
In an in vitro study that investigated the mechanical involvement of platelet-derived exosomes in endothelial cell apoptosis and the development of septic vascular dysfunction, the authors described the redox-reactive role of platelet-derived exosomes in vascular dysfunction in sepsis. In addition, carvedilol increases levels of ABCA1 in serum exosomes, which interferes with NF-beta B and Akt signaling to limit atherosclerosis (mouse exosomes in a mouse model) (1.However, the isolation of exosomes is a challenge and currently there are no reliable protocols that can isolate exosomes from other extracellular vesicles in a given biological specimen with absolute precision). In short, exosomes are immobilized on ExoView chips using affinity capture, usually against exosomal transmembrane proteins. In turn, these CD34+ exosomes usually contain miR-126 and miR-130a derived from proangiogenic hematopoietic stem cells, which contribute to the angiogenic capacity of exosomes (10).
In addition, combinatorial treatment with microvesicles and exosomes reduces infarct size, facilitates functional recovery and increases neoangiogenesis (human exosomes in a mouse model) (9.The clinical trial NCT03478410 entitled, “The role of exosomes derived from epicardial fat in atrial fibrillation”, aims to evaluate the biomarker and the therapeutic potential of exosomes derived from epicardial fat in patients with atrial fibrillation. In rats with experimentally induced stroke, intravenous administration of MSC-derived exosomes improves function and promotes neurogenesis, angiogenesis and neurite remodeling through miR-133b (mouse exosomes in a mouse model) (98, 10). This group isolated serum exosomes from healthy adults on an empty stomach and after consuming a high-calorie (postprandial) meal and found that everyone could take a free fatty acid analog, but the anal exosomes had higher levels of the CD36 scavenger receptor content and a higher lipid content. In conclusion, exosomal biomarkers are still in an early phase of discovery, but it is expected that, in the near future, exosomes will be a powerful diagnostic marker for determining the progress of cardiovascular disease that is already in its early stages. We have also reviewed the engineering of endogenous exosomes and presented some novel methods for the generation and design of synthetic exosomes that deliver therapeutic agents to the heart.
Combining with other therapies to improve the therapeutic effect is another option for the therapeutic function of Exosomes. Exosomes are involved in CVs by carrying specific exosomal loads, either promoting or limiting disease. CPC-derived exosomes with high levels of miR-451 that respond to GATA4 inhibit cardiomyocyte apoptosis (exosomes from mice in a mouse model) (10). Since certain exosomes exacerbate CVD (10), one therapeutic approach is to limit the secretion of so-called harmful exosomes.
This is because without obtaining the number of exosomes, data on exosome components (miRNA, proteins) would not be normalized with respect to the number of exosomes.
