Extracellular vesicle-mediated targeting strategies for long-term health benefits in gestational diabetes

Extracellular vesicles (EVs) are critical mediators of cell communication, playing important roles in regulating molecular cross-talk between different metabolic tissues and influencing insulin sensitivity in both healthy and gestational diabetes mellitus (GDM) pregnancies. The ability of EVs to transfer molecular cargo between cells imbues them with potential as therapeutic agents. During pregnancy, the placenta assumes a vital role in metabolic regulation, with multiple mechanisms of placenta-mediated EV cross-talk serving as central components in GDM pathophysiology. This review focuses on the role of the placenta in the pathophysiology of GDM and explores the possibilities and prospects of targeting the placenta to address insulin resistance and placental dysfunction in GDM. Additionally, we propose the use of EVs as a novel method for targeted therapeutics in treating the dysfunc-tional placenta. The primary aim of this review is to comprehend the current status of EV targeting approaches and assess the potential application of these strategies in placental therapeutics, thereby delivering molecular cargo and improving maternal and fetal outcomes in GDM. We propose that EVs have the potential to revolutionize GDM management, offering hope for enhanced maternal-fetal health outcomes and more effective treatments.

Automated summary

Extracellular vesicles (EVs) play important roles in cell communication and are crucial for regulating molecular cross-talk between different metabolic tissues, influencing insulin sensitivity in both healthy and gestational diabetes mellitus (GDM) pregnancies. The placenta has a vital role in metabolic regulation during pregnancy and placenta-mediated EV cross-talk serves as a central component in GDM pathophysiology. Targeting the placenta and using EVs as therapeutic agents show potential for improving insulin resistance and placental dysfunction in GDM.