The potential of exosomes as therapeutics in cardiovascular diseases. Exosomes, which range in size from 30 to 150 nm, as initially identified by electron microscopy in 1946, are one of the extracellular vesicles (EVs) produced by many cells and have been the subject of many studies; initially, they were considered cellular debris with the belief that cells produced exosomes to maintain homeostasis. Nowadays, electric vehicles secreted by different cells have been discovered to play a vital role in cellular communication and are usually secreted under both physiological and pathological conditions. Due to the presence of different markers and ligands on the surface of exosomes, they have paracrine, endocrine and autocrine effects in some cases.
Immune cells, like other cells, can secrete exosomes that interact with surrounding cells through these vesicles. Exosomes derived from immune system cells (EIE) induce different responses, such as increasing and decreasing the transcription of several genes and regulating cytokine production. This review analyzes the function of exosomes derived from innate and acquired immune cells, their role in the pathogenesis of immune diseases, and their therapeutic mechanisms. 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.
Therefore, the effects of untreated exosomes may be multidirectional, indicating that the specificity of therapies based on untreated exosomes may be in question. Exosomes derived from MSCs can reach the brain, liver, lungs and spleen after intravenous injection (4), while exosomes derived from mature dendritic cells (DCs) accumulate mainly in the liver and spleen and peak 4 h after injection (21, 4); this is similar to the innate localization capacity of mature DCs that migrate to peripheral lymphoid organs. Due to two successive invaginations of the plasma membrane (figure), exosomes have the same membrane orientation as the plasma membrane (therefore, the orientation of the proteins on the surface of the exosomes is the same as that of the plasma membrane). In addition, only a small fraction of exosomes have been discovered in immune regulation (1), and it is difficult to infer the potential applications of these exosomes in cardiac repair due to the lack of studies in this area. Stem cell therapy for myocardial infarction has long been a focus of research over the past two decades, and exosomes secreted by stem cells are important active substances and have immunomodulation, antiapoptosis, antifibrotic and angiogenesis therapeutic effects similar to those of stem cells themselves.
In some cases, exosome attachment is sufficient to exert modifications on the target cell, but in other cases, the exosome must be internalized in addition to the attachment. From a manufacturing process perspective, exosome-based therapies simplify preparation and sterilization and require less storage (50), considerably reducing the total cost compared to stem cell therapies. A doxorubicin delivery platform that uses natural membrane vesicle exosomes designed for tumor treatment directed. Therefore, in this review, we will summarize the characteristics and biological function of exosomes and the functions of immune cell-derived and stem cell-derived exosomes in cardiac repair by modulating immune responses after myocardial infarction.
Since exosomes are increasingly being investigated and applied to cardiovascular diseases such as myocardial infarction (50), it can be expected that, based on well-established cellular immunotherapies, immune cell exosomes represent new effective alternatives for patients. We have summarized the potential mechanisms of exosomes in cardiovascular pathophysiology to further support the potential applications of exosomes as biomarkers and therapeutic agents for cardiovascular diseases. In addition, as a result of the exogenous administration of AT1R-rich exosomes to attack cardiomyocytes, skeletal muscle cells, and mesenteric resistance vessels, mice inactivated with AT1R showed a blood pressure response to the Ang II infusion, providing functional evidence that exosomes significantly improve responsiveness to blood pressure.
