Objectives: A review of over 300 articles examines exosomes' advantages and disadvantages. Exosomes regulate complex intracellular pathways and have been used as biomarkers, cell-free therapeutic agents, drug delivery carriers, exosome kinetics, and cancer vaccines. The complex cargo of exosomes is readily accessible via sampling of biological fluids (liquid biopsies). Proteins, metabolites, and nucleic acids delivered by exosomes into recipient cells effectively alter their biological response. Such exosome-mediated responses can be healing or the exact opposite: It can promote disease and/or aging.
Introduction: The clinical application of exosomes faces various questions and challenges. In addition, exosome-based clinical trials are required to conform to specific good manufacturing practices (GMP). A GMP-grade exosome production method comprises the type of cells, culture environment, cultivation system, and culture medium. Further purification is essential after production, usually divided into three-step process. The third subject in GMP of exosomes is the establishment of characterization and identification method, comprising physical configuration and bioactivity function characteristics.
Materials / method: Exosomes can deliver proteins, metabolites and nucleic acids into recipient cells altering their biological response and restraining or, the exact opposite, promoting the course of disease. Despite the exosomes’ miraculous effects on several diseases, including cancer where exosomes are used as a vaccine, there is clinical evidence that exosomes may promote viral infection by enabling the spreading of a virus into the body. Viruses can use exosomes like a “Trojan horse” to gain access to our cells and disseminate the infection.
Results: It has been proposed that multiple viruses may package within exosomes, a process that would promote multiplicities of infection and viral genetic cooperativity. Recent studies have shown that exosomes released from bacteria-infected macrophages are pro-inflammatory. Blocking the generation of exosomes appears to be protective against sepsis-induced inflammatory response and cardiac dysfunction. Overall, the blockade of exosome generation in sepsis dampens the sepsis-triggered inflammatory response and thereby, improves cardiac function and survival.
Conclusion: Exosomes contain many constituents of a cell, including DNA, RNA, miRNAs, lipids, metabolites, cytosolic and cell-surface proteins. The physiological purpose of generating exosomes remains largely unknown. One speculated role is that exosomes likely remove excess and/or unnecessary constituents from cells to maintain cellular homeostasis. Exosomes' functional heterogeneity can result in one set of exosomes inducing cell survival, another set inducing apoptosis, and a different set inducing immunomodulation, etc. Due to their complexity, more research on exosomes is necessary.
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