Exosomes in Atherosclerosis, a Double-Edged Sword: Their Role in Disease Pathogenesis and Their Potential as Novel Therapeutics

Cardiovascular disease (CAD) due to atherosclerosis is a major cause of death worldwide. The development of atherosclerosis involves intercellular communication facilitated by exosomes secreted from vascular endothelial cells (VECs), vascular smooth muscle cells (VSMCs), immune cells, and platelets. In this review, we summarize the current understanding of exosome biogenesis and uptake, and discuss atherogenic and atheroprotective functions of exosomes secreted from these cell types. In addition, we examine the potential of enhancing the therapeutic and targeting ability of exosomes exhibiting atheroprotective function by drug loading and surface modification with targeting ligands. We conclude with current challenges associated with exosome engineering for therapeutic use.

Automated summary

Cardiovascular disease caused by atherosclerosis is a major global health concern. Exosomes secreted by various cell types play a crucial role in the development of atherosclerosis and have both atherogenic and atheroprotective functions. Enhancing the therapeutic potential of atheroprotective exosomes through drug loading and surface modification is a promising approach, but current challenges exist in exosome engineering for therapeutic applications.