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Extracellular Vesicles as Drug Delivery Systems in Organ Transplantation: The Next Frontier

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Joseph Blommer et al.

Summary: The protein cargo of neuronal extracellular vesicles may serve as a biomarker for cognitive impairment in Parkinson's disease, with differences in alpha-synuclein, phosphorylated tau, and proteins associated with insulin signaling observed between patients with and without cognitive impairment. These findings could provide insights into the underlying pathogenic processes and improve diagnosis and prognosis of Parkinson's disease. Plasma samples from 273 participants were used in the study, and immunoassays were utilized to quantify biomarkers in plasma extracellular vesicles enriched for neuronal origin. Alpha-synuclein, phosphorylated tau, and insulin receptor substrate-1 phosphorylated tyrosine showed diagnostic classification contributions between groups, indicating that both alpha-synuclein and tau pathologies, along with impaired insulin signaling, may underlie Parkinson's disease with cognitive impairment. Plasma neuronal extracellular vesicles biomarkers may inform cognitive prognosis in Parkinson's disease.
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Free complement and complement containing extracellular vesicles as potential biomarkers for neuroinflammatory and neurodegenerative disorders

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Summary: The complement system is involved in neuroinflammatory disorders like Alzheimer's disease and multiple sclerosis. Measuring complement levels in biofluids could potentially serve as a biomarker for these diseases. Extracellular vesicles (EVs) that contain complement proteins may provide a platform to improve the diagnostic power of these proteins.

FRONTIERS IN IMMUNOLOGY (2023)

Article Biology

An epithelial-to-mesenchymal transition induced extracellular vesicle prognostic signature in non-small cell lung cancer

Richard J. Lobb et al.

Summary: Despite advancements in therapy, lung cancer remains a leading cause of cancer-related death globally. Non-small cell lung cancer (NSCLC) patients have a low five-year survival rate and current staging methods may not accurately predict outcomes. Epithelial-to-mesenchymal transition (EMT) and associated protein changes in extracellular vesicles may serve as prognostic markers in NSCLC patients, enabling personalized treatment decisions.

COMMUNICATIONS BIOLOGY (2023)

Review Cardiac & Cardiovascular Systems

Extracellular vesicles and atherosclerotic peripheral arterial disease

Paul A. Brown et al.

Summary: Atherogenesis is a complex process involving chronic inflammation and the participation of various cell types and molecules. Extracellular vesicles play a crucial role in this process, contributing to monocyte transmigration, foam cell formation, smooth muscle cell proliferation and migration, leukocyte transmigration, and thrombosis. Peripheral arterial disease, a common type of peripheral vascular disease, is characterized by impaired blood supply due to atherosclerosis. Elevated levels of extracellular vesicles have been found in patients with peripheral arterial disease and are implicated in the development of atherosclerosis. However, extracellular vesicles also have the potential to deliver cargo with atheroprotective effects, offering opportunities for therapeutic angiogenesis in the management of peripheral arterial disease.

CARDIOVASCULAR PATHOLOGY (2023)

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Regenerative potential of epicardium-derived extracellular vesicles mediated by conserved miRNA transfer

Cristina Villa del Campo et al.

Summary: Researchers investigated the signaling of epicardial EVs to promote cardiomyocyte proliferation in infarcted mouse hearts and a human myocardial injury model. Deep RNA-sequencing revealed conserved miRs in exosomes derived from mouse and human epicardium, and the combination of these miRs replicated the therapeutic effects of promoting cardiomyocyte proliferation.

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A novel phage display based platform for exosome diversity characterization

Domenico Maisano et al.

Summary: This study presents an innovative approach to identify, isolate, and characterize disease-related exosomes based on their antigenic reactivities. The strategy can be immediately applied to any disease involving exosomes. The identification of specific markers and their association with exosome subtypes, along with the engineering of target-guided exosome-like particles, could be crucial for the effective clinical adoption of exosomes.

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Liver Transplantation Outcomes From Controlled Circulatory Death Donors SCS vs in situ NRP vs ex situ NMP

Rohit Gaurav et al.

Summary: NRP and NMP were associated with better early liver function compared to SCS, whereas NRP was associated with superior preservation of the biliary system.

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Pharmacological testing of therapeutics using normothermic machine perfusion: A pilot study of 2,4-dinitrophenol delivery to steatotic human livers

Samuel J. Tingle et al.

Summary: This study demonstrates the ability of normothermic machine perfusion (NMP) as a platform for pharmacological testing. Using 25 hours of NMP on human livers, the researchers showed that a drug called 2,4-dinitrophenol (DNP) was rapidly eliminated by the ex vivo liver, resulting in only transient drug effects. This highlights the importance of assessing pharmacokinetics when delivering therapeutics during NMP, especially for organs involved in drug elimination. Rigorous pharmacological testing is needed to unlock the potential of NMP as a clinical drug-delivery platform.

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Extracellular vesicles derived from mesenchymal stromal cells as nanotherapeutics for liver ischaemia-reperfusion injury by transferring mitochondria to modulate the formation of neutrophil extracellular traps

Tongyu Lu et al.

Summary: This study shows that mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) can reduce neutrophil extracellular traps (NETs) formation in liver tissue, improve mitochondrial function in neutrophils, and have therapeutic potential for liver ischemia-reperfusion injury (IRI).

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Circulating cell-specific extracellular vesicles as biomarkers for the diagnosis and monitoring of chronic liver diseases

Lauren A. Newman et al.

Summary: This study summarizes the contribution of extracellular vesicles (EVs) to normal liver function and chronic liver diseases. It explores the use of circulating EV biomarkers for monitoring disease status and treatment response. Emerging technologies for selectively isolating and analyzing circulating EVs derived only from hepatic cells show promise for biomarker platforms in chronic liver diseases.

CELLULAR AND MOLECULAR LIFE SCIENCES (2022)

Article Cardiac & Cardiovascular Systems

MicroRNA Expression Profiles of Epicardial Adipose Tissue-Derived Exosomes in Patients with Coronary Atherosclerosis

Jinxing Liu et al.

Summary: This study aimed to establish miRNA expression profiles of epicardial adipose tissue-derived exosomes in patients with coronary atherosclerosis. The results showed differential expression of miRNAs in coronary artery disease patients, suggesting their potential involvement in cell survival, apoptosis, proliferation, and differentiation.

REVIEWS IN CARDIOVASCULAR MEDICINE (2022)

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Extracellular Vesicles Derived from Mesenchymal Stromal Cells Delivered during Hypothermic Oxygenated Machine Perfusion Repair Ischemic/Reperfusion Damage of Kidneys from Extended Criteria Donors

Teresa Rampino et al.

Summary: This study explores the use of hypothermic oxygenated perfusion (HOPE) combined with extracellular vesicles (EV) derived from mesenchymal stromal cells as a new strategy for organ preservation. The results show that EV delivery during HOPE can effectively reduce ischemic damage, prevent reoxygenation-dependent injury, and improve transplant outcomes. This study is significant in increasing the donor pool and improving transplantation success.

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Umbilical Cord Mesenchymal Stem Cell-Derived Small Extracellular Vesicles Deliver miR-21 to Promote Corneal Epithelial Wound Healing through PTEN/PI3K/Akt Pathway

Xiaolong Liu et al.

Summary: Human umbilical cord mesenchymal stem cell-derived small extracellular vesicles can enhance corneal epithelial wound healing by inhibiting PTEN through miR-21 transfer and activating the PI3K/Akt signaling pathway, promoting epithelial cell proliferation and migration.

STEM CELLS INTERNATIONAL (2022)

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The Fatal Circle of NETs and NET-Associated DAMPs Contributing to Organ Dysfunction

Helena Block et al.

Summary: The innate immune system acts as the first line of defense against invading pathogens or sterile injuries. Neutrophils play a crucial role in fighting infection and healing injuries, with the release of neutrophil extracellular traps (NETs) being an important mechanism. Recent studies have shown that NETs can have detrimental effects in certain diseases.
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Extracellular vesicles through the blood-brain barrier: a review

Hector M. Ramos-Zaldivar et al.

Summary: Extracellular vesicles (EVs) are non-replicative particles released from cells. The mechanism of bidirectional EVs transport across the blood-brain barrier (BBB) is poorly understood. Current research lacks direct visualization of EVs transcytosis through the BBB in mammals, with most studies relying on in vitro models that do not consider the combined effect of all cellular layers constituting the BBB. Further research using in vitro and in vivo methodologies is needed to clarify these issues.

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Small extracellular vesicles from young adipose-derived stem cells prevent frailty, improve health span, and decrease epigenetic age in old mice

Jorge Sanz-Ros et al.

Summary: This study found that treatment of old animals with ADSC-sEVs derived from young animals can improve various parameters associated with aging and reduce frailty. This treatment induces proregenerative effects and reduces oxidative stress, inflammation, and senescence in muscle and kidney. Additionally, tissue epigenetic age decreases and metabolome shifts to a youth-like pattern after this treatment.

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Extracellular vesicle fusion visualized by cryo-electron microscopy

Mattia I. Morandi et al.

Summary: This study developed an in vitro biophysical assay to investigate membrane fusion of extracellular vesicles (EVs) and benchmarked it against viral fusion. The results showed that EVs and retroviruses can fuse with liposomes in a pH- and protein-dependent manner, and the stages of membrane fusion were directly visualized using cryo-electron tomography. In addition, the study found that EVs remain fusogenic after acidification and reneutralization, which is different from most retroviruses.

PNAS NEXUS (2022)

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Novel delivery of cellular therapy to reduce ischemia reperfusion injury in kidney transplantation

Emily R. Thompson et al.

Summary: Ex vivo normothermic machine perfusion (NMP) of donor kidneys provides a platform for direct delivery of cellular therapeutics, such as Multipotent Adult Progenitor Cells (MAPC(R)), to optimize organ quality prior to transplantation. This study demonstrated improved urine output, decreased injury biomarker expression, and regulation of inflammatory factors in MAPC-treated kidneys during NMP, suggesting a promising strategy for organ reconditioning before transplantation.

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Cytokine absorption during human kidney perfusion reduces delayed graft function-associated inflammatory gene signature

John R. Ferdinand et al.

Summary: The study found that cold storage led to a global reduction in gene expression, while normothermic machine perfusion (NMP) could upregulate oxidative phosphorylation genes, but also potentially increase the expression of immune and inflammatory pathway genes. Organs with prolonged delayed graft function (DGF) showed higher levels of inflammatory gene expression, and the use of a hemoadsorber could potentially attenuate this and increase OXPHOS pathway genes.

AMERICAN JOURNAL OF TRANSPLANTATION (2021)

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Extracellular Vesicles in Skin Wound Healing

Deimante Narauskaite et al.

Summary: Extracellular vesicles (EVs) play a crucial role in wound healing and potential therapeutic interventions. In addition to their natural healing capacity, EVs can be engineered to carry specific cargo for targeted pharmaceutical purposes, making them a promising treatment modality.

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Single Particle Automated Raman Trapping Analysis of Breast Cancer Cell-Derived Extracellular Vesicles as Cancer Biomarkers

Jelle Penders et al.

Summary: The study focuses on extracellular vesicles (EVs) and introduces a high-throughput label-free EV analysis method for cancer diagnosis and monitoring, eliminating interpreter bias. By developing a dedicated device and using dimensional reduction analysis (DRA), a convenient and comprehensive approach for comparing multiple EV spectra is demonstrated. The study shows the high sensitivity and specificity of the dedicated SPARTA system in differentiating cancer and noncancer EVs, and its consistent predictive ability across multiple EV isolations.

ACS NANO (2021)

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Flow Cytometry Analysis of Circulating Extracellular Vesicle Subtypes from Fresh Peripheral Blood Samples

Marco Marchisio et al.

Summary: The study optimized a procedure using PFC to identify and separate circulating EVs from different cell origins, with the use of LCD staining being essential for PFC detection and sorting of EVs from fresh body fluids.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

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Utility of Claudin-3 in extracellular vesicles from human bile as biomarkers of cholangiocarcinoma

Chisaki Ikeda et al.

Summary: This study isolated EVs from human bile using EDEG and performed proteomic analysis, identifying Claudin-3 as a useful biomarker for CCA. The diagnostic accuracy was high with AUC 0.945 and sensitivity and specificity of 87.5%.

SCIENTIFIC REPORTS (2021)

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Exosomal miRNA as peripheral biomarkers in Parkinson's disease and progressive supranuclear palsy: A pilot study

Ida Manna et al.

Summary: This study demonstrated the potential of exosomal miRNAs as biomarkers to differentiate between Parkinson's disease and Progressive Supranuclear Paralysis, with specific miRNAs like miR-21-3p, miR-22-3p, miR-223-5p, miR-425-5p, miR-21-3p, and miR-199a-5p showing promise in accurate discrimination. The classifier consisting of six exosomal miRNAs had high diagnostic sensitivity and specificity in distinguishing PSP from PD.

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Human milk extracellular vesicle miRNA expression and associations with maternal characteristics in a population-based cohort from the Faroe Islands

Allison Kupsco et al.

Summary: Human milk extracellular vesicles (EVs) containing microRNAs (miRNAs) play a critical role in infant cognitive, immune, and cardiometabolic functions. The expression of many top-cluster human milk EV-miRNAs is highly correlated, and they are involved in pathways related to the endocrine system, cellular community, neurodevelopment, and cancers. Further studies are needed to elucidate the determinants of human milk EV-miRNAs and their impact on health outcomes.

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Extracellular vesicles in pancreatic cancer progression and therapies

Chao-Hui Chang et al.

Summary: Pancreatic cancer is a leading cause of cancer-related deaths worldwide due to delayed diagnosis and limited treatments. Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers, with extracellular vesicles playing a crucial role in regulating tumor growth and metastasis. Understanding the factors in EVs derived from pancreatic ductal adenocarcinoma can provide insights into potential early diagnosis and therapeutic strategies against this deadly cancer.

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Mengrou Lu et al.

Summary: Extracellular vesicles play important roles in autoimmune diseases, both in disease pathogenesis and as potential treatments. Understanding the link between cellular stress and EV biogenesis and intercellular trafficking is crucial for advancing our understanding of autoimmune diseases. EVs derived from various cell types contain a wide range of molecules and have diverse physiological effects, showing promise as potential treatments for autoimmune diseases.

FRONTIERS IN IMMUNOLOGY (2021)

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Ex Vivo Mesenchymal Stem Cell Therapy to Regenerate Machine Perfused Organs

Christina Bogensperger et al.

Summary: Transplantation is limited by the shortage of healthy donor organs, but ex situ machine perfusion has the potential to expand the donor pool. Mesenchymal stem cells are considered as a tool with the potential to improve organs, but clinical benefits have not been conclusively demonstrated.

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Exosome-based delivery of super-repressor IκBα ameliorates kidney ischemia-reperfusion injury

Seonghun Kim et al.

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Extracellular vesicles as a next-generation drug delivery platform

Inge Katrin Herrmann et al.

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NATURE NANOTECHNOLOGY (2021)

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Nicola De Stefano et al.

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Rachel R. Mizenko et al.

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Yi-Te Lee et al.

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Christina F. Budden et al.

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miR-4732-3p in Extracellular Vesicles From Mesenchymal Stromal Cells Is Cardioprotective During Myocardial Ischemia

Rafael Sanchez-Sanchez et al.

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