Abstract
Extracellular vesicles (EVs) mediate intercellular communication by transferring genetic material, proteins and organelles between different cells types in both health and disease. Recent evidence suggests that these vesicles, more than simply diagnostic markers, are key mediators of the pathophysiology of acute respiratory distress syndrome (ARDS) and other lung diseases. In this review, we will discuss the contribution of EVs released by pulmonary structural cells (alveolar epithelial and endothelial cells) and immune cells in these diseases, with particular attention to their ability to modulate inflammation and alveolar-capillary barrier disruption, a hallmark of ARDS. EVs also offer a unique opportunity to develop new therapeutics for the treatment of ARDS. Evidences supporting the ability of stem cell-derived EVs to attenuate the lung injury and ongoing strategies to improve their therapeutic potential are also discussed.
Highlights
Acute respiratory distress syndrome (ARDS) is the major cause of acute respiratory failure in the intensive care units (ICUs) and carries a high mortality rate (Thompson et al, 2017)
Hypoxia-Treated Mesenchymal Stem Cells Mesenchymal stem cells are routinely cultured under ambient oxygen conditions (21% O2) despite the physiological environment in the bone marrow and other tissues is hypoxic, with oxygen tension ranging from 2 to 12% O2
Extracellular vesicles play a crucial role in the onset and progression of inflammation and pulmonary damage during ARDS
Summary
Acute respiratory distress syndrome (ARDS) is the major cause of acute respiratory failure in the intensive care units (ICUs) and carries a high mortality rate (Thompson et al, 2017). Risk factors for this condition include infection, trauma or other systemic conditions. Management is exclusively supportive and the lack of approved pharmacological therapies reflects major deficiencies in our understanding of the pathogenesis of ARDS. In late December 2019, an outbreak of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified. With a high rate of transmission and mortality, the SARS-CoV-2 infection (COVID-19) has become a global threat which demands effective treatments beyond supportive therapies (Zheng, 2020)
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