Roles and Clinical Applications of Exosomes in Cardiovascular Disease

Abstract

Despite substantial improvements in therapeutic strategies, cardiovascular disease (CVD) is still among the leading causes of mortality and morbidity worldwide. Exosomes, extracellular vesicles with a lipid bilayer membrane of endosomal origin, have been the focus of a large body of research in CVD. Exosomes not only serve as carriers for signal molecules responsible for intercellular and interorgan communication underlying CVD pathophysiology but also are bioactive agents which are partly responsible for the therapeutic effect of stem cell therapy of CVD. We here review recent insights gained into the role of exosomes in apoptosis, hypertrophy, angiogenesis, fibrosis, and inflammation in CVD pathophysiology and progression and the application and mechanisms of exosomes as therapeutic agents for CVD.

Figure 1

The roles of exosomes in the pathophysiology of cardiovascular diseases. Exosomes serve as the messengers exchanging bioinformation among cardiomyocytes, fibroblasts, endothelial cell, and the immune system. The molecules transported by exosomes regulate the hypertrophy, apoptosis, fibrosis, angiogenesis, and immune response in the recipient cells; those exerting adverse effects are depicted in red, while those depicted in green and black exert beneficial and neutral effects in the corresponding pathological process.

Figure 2

Application of exosomes in the treatment of cardiovascular diseases. Multiple stem cells, namely, mesenchymal stromal cells, cardiosphere-derived cells, cardiac progenitor cells, induced pluripotent stem cells, and embryonic stem cells, secrete exosomes containing therapeutic molecules to modulate the macrophage polarization, cardiomyocyte apoptosis, angiogenesis, and other responses in cardiac injury.