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Review
. 2021 Apr;10(4):1878-1889.
doi: 10.21037/tau-20-1039.

Urinary extracellular vesicles: a rising star in bladder cancer management

Fumihiko Urabe  1   2 , Takahiro Kimura  1 , Kagenori Ito  1   2 , Yusuke Yamamoto  2 , Shunsuke Tsuzuki  1 , Jun Miki  1   3 , Takahiro Ochiya  4 , Shin Egawa  1
Affiliations
Review

Urinary extracellular vesicles: a rising star in bladder cancer management

Fumihiko Urabe et al. Transl Androl Urol. 2021 Apr.

Abstract

Clinically, the detection of bladder cancer (BCa) typically requires cystoscopy, which is potentially harmful and sometimes accompanied by adverse effects. Thus, new biomarkers are desirable for improving the management of BCa. Recently, "liquid biopsy" has received enormous attentions and has been extensively studied due to its promising clinical implication for precise medicine. Especially, extracellular vesicles (EVs) have attracted strong interest as a potential source of biomarkers. EVs have been reported to be found in almost all types of body fluids and are easy to collect. In addition, EVs tightly reflect the current state of the disease by inheriting specific biomolecules from their parental cells. Urinary EVs have gained great scientific interest in the field of BCa biomarker research since urine is in direct contact with BCa and can contain large amounts of EVs from the tumour microenvironment. To date, various kinds of biomolecules, including noncoding RNAs, mRNAs, and proteins, have been investigated as biomarkers in urinary EVs. In this narrative review, we summarize the recent advances regarding urinary EVs as non-invasive biomarkers in patients with BCa. The current hurdles in the clinical implications of EV-based liquid biopsy and the potential applications of EV research are also discussed.

Keywords: Extracellular vesicles (EVs); biomarker; bladder cancer (BCa); exosome.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-1039). The series “Urinary Biomarkers of Urothelial Malignancies” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Clinical application of extracellular vesicles (EVs) in bladder cancer management. Urinary EVs are likely to be clinically useful biomarkers for bladder cancer. EV-associated biomolecules can be examined using several modalities, including real-time PCR, western blotting, and ExoScreen assays and microfluidic devices. Three therapeutic applications have been proposed: 1. inhibition of EV secretion, 2. elimination of circulating EVs, and 3. disruption of EV absorption. These EV-targeted strategies may add additional value to existing therapeutic methods.
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