The Utility of Exosomes in Diagnosis and Therapy of Diabetes Mellitus and Associated Complications

Abstract

Diabetes mellitus and the associated complications are metabolic diseases with high morbidity that result in poor quality of health and life. The lack of diagnostic methods for early detection results in patients losing the best treatment opportunity. Oral hypoglycemics and exogenous insulin replenishment are currently the most common therapeutic strategies, which only yield temporary glycemic control rather than curing the disease and its complications. Exosomes are nanoparticles containing bioactive molecules reflecting individual physiological status, regulating metabolism, and repairing damaged tissues. They function as biomarkers of diabetes mellitus and diabetic complications. Considering that exosomes are bioactive molecules, can be obtained from body fluid, and have cell-type specificity, in this review, we highlight the multifold effects of exosomes in the pathology and therapy of diabetes mellitus and diabetic complications.

Keywords: biomarkers; diabetes mellitus; diagnosis; exosomes; mesenchymal stem cells; therapy.

Figure 1

Analysis of exosomes from patients with diabetes mellitus. Diabetes mellitus and diabetic complications have pathological change before organic damage in exosomes derived from body fluids. We can collect the serum, plasma, and urine non-invasively and analyze the counts and contents such as DNA, RNA, and protein depending on the differences between healthy control by choosing the significant biomarker for early diagnosis of diabetes mellitus and diabetic complications.

Figure 2

Potential approach of exosomes derived from mesenchymal stem cell in diabetes mellitus and diabetic complication repair. Exosome derived from mesenchymal stem cell may downregulate blood glucose through reversing peripheral tissue (liver and muscle) insulin resistance and increasing β-cell survival during remission of diabetes mellitus; exosome derived from mesenchymal stem cell can inhibit apoptosis, oxidative stress, and immune reaction to reduce vascular or neuron injury and carry growth factors to increase damaged tissue or cell repair, which may participate in alleviating diabetic complications.