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Exosomes as Promising Nanostructures in Diabetes Mellitus: From Insulin Sensitivity to Ameliorating Diabetic Complications

期刊

INTERNATIONAL JOURNAL OF NANOMEDICINE
卷 17, 期 -, 页码 1229-1253

出版社

DOVE MEDICAL PRESS LTD
DOI: 10.2147/IJN.S350250

关键词

diabetes mellitus; insulin resistance; exosome; glucose uptake; lipid metabolism

资金

  1. National Institute of Biomedical Imaging and Bioengineering [5T32EB009035]
  2. Singapore Ministry of Education Tier 2 [MOET2EP30120-0016]
  3. National Medical Research Council of Singapore
  4. Singapore Ministry of Education under its Research Centers of Excellence initiative to Cancer Science Institute of Singapore
  5. National University of Singapore

向作者/读者索取更多资源

Exosomes have great potential in the treatment of diabetes mellitus, as they can regulate glucose and lipid metabolism, ameliorate apoptosis and endoplasmic reticulum stress in beta cells, and influence insulin resistance/sensitivity.
Diabetes mellitus (DM) is among the chronic metabolic disorders that its incidence rate has shown an increase in developed and wealthy countries due to lifestyle and obesity. The treatment of DM has always been of interest, and significant effort has been made in this field. Exosomes belong to extracellular vesicles with nanosized features (30-150 nm) that are involved in cell-to-cell communication and preserving homeostasis. The function of exosomes is different based on their cargo, and they may contain lipids, proteins, and nucleic acids. The present review focuses on the application of exosomes in the treatment of DM; both glucose and lipid levels are significantly affected by exosomes, and these nanostructures enhance lipid metabolism and decrease its deposition. Furthermore, exosomes promote glucose metabolism and affect the level of glycolytic enzymes and glucose transporters in DM. Type I DM results from the destruction of beta cells in the pancreas, and exosomes can be employed to ameliorate apoptosis and endoplasmic reticulum (ER) stress in these cells. The exosomes have dual functions in mediating insulin resistance/sensitivity, and M1 macrophage-derived exosomes inhibit insulin secretion. The exosomes may contain miRNAs, and by transferring among cells, they can regulate various molecular pathways such as AMPK, PI3K/Akt, and beta-catenin to affect DM progression. Noteworthy, exosomes are present in different body fluids such as blood circulation, and they can be employed as biomarkers for the diagnosis of diabetic patients. Future studies should focus on engineering exosomes derived from sources such as mesenchymal stem cells to treat DM as a novel strategy.

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