Exosome-mediated regulatory mechanisms in skeletal muscle: a narrative review

Skeletal muscle plays a paramount role in physical activity, metabolism, and energy balance, while its homeostasis is being challenged by multiple unfavorable factors such as injury, aging, or obesity. Exosomes, a subset of extracellular vesicles, are now recognized as essential mediators of intercellular communication, holding great clinical potential in the treatment of skeletal muscle diseases. Herein, we outline the recent research progress in exosomal isolation, characterization, and mechanism of action, and emphatically discuss current advances in exosomes derived from multiple organs and tissues, and engineered exosomes regarding the regulation of physiological and pathological development of skeletal muscle. These remarkable advances expand our understanding of myogenesis and muscle diseases. Meanwhile, the engineered exosome, as an endogenous nanocarrier combined with advanced design methodologies of biomolecules, will help to open up innovative therapeutic perspectives for the treatment of muscle diseases.

Automated summary

Skeletal muscle plays a crucial role in physical activities, metabolism, and energy balance, but its homeostasis is challenged by various factors such as injury, aging, and obesity. Exosomes, a type of extracellular vesicles, have emerged as important mediators in intercellular communication and hold great potential for treating skeletal muscle diseases. This review outlines recent research progress in exosomal isolation, characterization, mechanism of action, and highlights advancements in exosomes derived from different organs and tissues, as well as engineered exosomes, which have the ability to regulate the physiological and pathological development of skeletal muscle. These advancements enhance our understanding of muscle formation and diseases, and the utilization of engineered exosomes as nanocarriers with advanced biomolecule design methodologies offers innovative therapeutic perspectives for muscle diseases.