Abstract
Cardiovascular diseases (CVD) represent the leading cause of morbidity and mortality globally. The emerging role of extracellular vesicles (EVs) in intercellular communication has stimulated renewed interest in exploring the potential application of EVs as tools for diagnosis, prognosis, and therapy in CVD. The ubiquitous nature of EVs in biological fluids presents a technological advantage compared to current diagnostic tools by virtue of their notable stability. EV contents, such as proteins and microRNAs, represent specific signatures of cellular activation or injury. This feature positions EVs as an alternative source of biomarkers. Furthermore, their intrinsic activity and immunomodulatory properties offer EVs unique opportunities to act as therapeutic agents per se or to serve as drug delivery carriers by acting as miniaturized vehicles incorporating bioactive molecules. In this article, we aim to review the recent advances and applications of EV-based biomarkers and therapeutics. In addition, the potential of EVs as a drug delivery and theranostic platform for CVD will also be discussed.
Highlights
Cardiovascular disease (CVD) encompasses a wide spectrum of pathologies of the heart and blood vessels including peripheral vascular disease, coronary artery disease, cerebrovascular disease, ischemic heart disease, and heart failure (HF) [1]
The high sensitivity of cardiac troponins I and T assays is offset by the poor diagnostic specificity for acute myocardial infarction (MI), and the plasma concentration of the B-type natriuretic peptides is often confounded by age and some non-CVD complications, such as renal dysfunction [4]
Various species of ribonucleic acids (RNA) have been identified in extracellular vesicles (EVs), including messenger RNA, transfer RNA, small interfering RNA, long-non-coding RNA and miRNA
Summary
Cardiovascular disease (CVD) encompasses a wide spectrum of pathologies of the heart and blood vessels including peripheral vascular disease, coronary artery disease, cerebrovascular disease, ischemic heart disease, and heart failure (HF) [1]. The high sensitivity of cardiac troponins I and T assays is offset by the poor diagnostic specificity for acute MI, and the plasma concentration of the B-type natriuretic peptides is often confounded by age and some non-CVD complications, such as renal dysfunction [4]. This imposes an urgent need for more refined diagnostic biomarkers, which can fill existing significant gaps, improve diagnostic certainty, and provide early risk stratification in CVD. Given their unique features (intrinsic bioactivities, immunomodulation, and sizes in the nanoscale), EVs have recently been proposed for therapeutics as well as drug delivery purposes
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