Abstract

Exosomes are nano-sized biovesicles of endocytic origin physiologically released by nearly all cell types into surrounding body fluids. They carry cell-specific cargos of protein, lipids, and genetic materials and can be selectively taken up by neighboring or distant cells. Since the intrinsic properties of exosomes are strictly influenced by the state of the parental cell and by the cellular microenvironment, the analysis of exosome origin and content, and their cell-targeting specificity, make them attractive as possible diagnostic and prognostic biomarkers. While the possible role of exosomes as messengers and a regenerative tool in cardiovascular diseases (CVDs) is actively investigated, the evidence about their usefulness as biomarkers is still limited and incomplete. Further complications are due to the lack of consensus regarding the most appropriate approach for exosome isolation and characterization, both important issues for their effective clinical translation. As a consequence, in this review, we will discuss the few information currently accessible about the diagnostic/prognostic potential of exosomes in CVDs and on the methodologies available for exosome isolation, analysis, and characterization.

Highlights

  • Since their discovery in the early 1980s [1,2], it has become clear that exosomes are essential mediators of cell-to-cell communication and contribute to many physiological and pathological aspects [3]

  • We decided to focus mainly on the potential application of exosomes as a diagnostic/prognostic tool in cardiovascular diseases (CVDs) and, as consequence, we discuss the pros and cons of methodologies used in exosome research

  • Exosomes provide several advantages as a potential biomarker: (1) they are extremely specific and sensitive since they carry biological cargo that reflect the pathophysiological condition of the parental cells; (2) they can be isolated from obtainable biofluids such as blood and urine [148]; (3) the biomolecules transported by exosomes, compared to free circulating counterparts, have an increased half-life since the exosomal membrane protects them from degradation [149,150,151,152]

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Summary

Introduction

Since their discovery in the early 1980s [1,2], it has become clear that exosomes are essential mediators of cell-to-cell communication and contribute to many physiological and pathological aspects [3]. The intrinsic properties of exosomes are strictly influenced by the state of the parental cell and by the cellular microenvironment Their specific way of formation makes them faithful messengers that carry information about the original cellular/tissue context in the form of cell-specific surface markers and/or membrane-enclosed biomolecules. The possible of exosomes in cardiovascular diseases (CVDs), in ischemic heart disease, as messengers or as a regenerative tool is actively investigated by several groups [18,19,20,21,22,23], but the evidence about their usefulness as a diagnostic and prognostic tool is still limited mainly due to.

Exosomesof
Exosome Isolation
Method
Ultracentrifugation
Schematic
Size-Based Isolation Methods
Immuno-Affinity Purification
Polymer-Based Precipitation
Microfluidics-Based Isolation Techniques
Exosome Characterization
Nanoparticle Tracking Analysis
Dynamic Light Scattering
Resistive Pulse Sensing
Electron Microscopy
Atomic Force Microscopy
Flow Cytometry
Raman Spectroscopy
Exoview Platform
Other Techniques
Clinical and Biomedical Values of Exosomes in CVDs
Therapeutic Potential of Exosomes in CVDs
Diagnostic Potential of Exosomes in Cardiovascular Diseases
Exosomes in Coronary Artery Disease
Exosomes in Heart Failure
Exosomes and Cerebrovascular Disease
Exosomes in Other CVDs
Concluding Observations
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