Extracellular vesicles in cardiovascular diseases

Abstract

Due to the continued high incidence and mortality rate worldwide, there is still a need to develop new strategies for the prevention, diagnosis and treatment of cardiovascular diseases (CVDs). Proper cardiovascular function depends on the coordinated interplay and communication between cardiomyocytes and noncardiomyocytes. Extracellular vesicles (EVs) are enclosed in a lipid bilayer and represent a significant mechanism for intracellular communication. By containing and transporting various bioactive molecules, such as micro-ribonucleic acids (miRs) and proteins, to target cells, EVs impart favourable, neutral or detrimental effects on recipient cells, such as modulating gene expression, influencing cell phenotype, affecting molecular pathways and mediating biological behaviours. EVs can be released by cardiovascular system-related cells, such as cardiomyocytes, endotheliocytes, fibroblasts, platelets, smooth muscle cells, leucocytes, monocytes and macrophages. EVs containing miRs and proteins regulate a multitude of diverse functions in target cells, maintaining cardiovascular balance and health or inducing pathological changes in CVDs. On the one hand, miRs and proteins transferred by EVs play biological roles in maintaining normal cardiac structure and function under physiological conditions. On the other hand, EVs change the composition of their miR and protein cargoes under pathological conditions, which gives rise to the development of CVDs. Therefore, EVs hold tremendous potential to prevent, diagnose and treat CVDs. The current article reviews the specific functions of EVs in different CVDs.

Keywords: Cardiovascular diseases; Molecular biology.

Fig. 1. Origins, contents and roles of extracellular vesicles.

Extracellular vesicles (EVs) are enclosed in a lipid bilayer and represent a by-product released by cells. In addition to direct cell-cell contact or the transport of secreted molecules, EVs also participate in intercellular communication. By containing and transporting various bioactive molecules, such as proteins, lipids, messenger ribonucleic acids (mRNAs), micro-ribonucleic acids (microRNAs, miRs) and deoxyribonucleic acids (DNAs), to target cells, EVs impart favourable, neutral or detrimental effects on recipient cells, such as modulating gene expression, influencing cell phenotype, affecting molecular pathways and mediating biological behaviours.

Fig. 2. Origins, contents and roles of extracellular vesicles in cardiovascular diseases.

Extracellular vesicles (EVs) can be released by cardiovascular system-related cells, such as cardiomyocytes, endotheliocytes, fibroblasts, platelets, smooth muscle cells (SMCs), leukocytes, monocytes and macrophages. On the one hand, EVs play biological roles in maintaining normal cardiac structure and function under physiological conditions. On the other hand, EVs change their composition under pathological conditions and contribute to the development of cardiovascular diseases (CVDs). Therefore, EVs hold tremendous potential to monitor and treat CVDs.

Fig. 3. Origins and roles of stem cell-derived extracellular vesicles.

Extracellular vesicles (EVs) mimic the cardioprotective properties of various stem cells, including mesenchymal stromal cells (MSCs), haematopoietic stem cells (HSCs) and induced pluripotent stem cell (iPSCs). These EVs modulate cardiomyocytes and endotheliocytes by stimulating cell proliferation, decreasing cell apoptosis, inhibiting cell autophagy, promoting angiogenesis, reducing tissue fibrosis, preventing cardiovascular injury, treating myocardial infarction and improving cardiac survival.