Exosomes in Glioma: Unraveling Their Roles in Progression, Diagnosis, and Therapy

Abstract

Gliomas, the most prevalent primary malignant brain tumors, present a challenging prognosis even after undergoing surgery, radiation, and chemotherapy. Exosomes, nano-sized extracellular vesicles secreted by various cells, play a pivotal role in glioma progression and contribute to resistance against chemotherapy and radiotherapy by facilitating the transportation of biological molecules and promoting intercellular communication within the tumor microenvironment. Moreover, exosomes exhibit the remarkable ability to traverse the blood-brain barrier, positioning them as potent carriers for therapeutic delivery. These attributes hold promise for enhancing glioma diagnosis, prognosis, and treatment. Recent years have witnessed significant advancements in exosome research within the realm of tumors. In this article, we primarily focus on elucidating the role of exosomes in glioma development, highlighting the latest breakthroughs in therapeutic and diagnostic approaches, and outlining prospective directions for future research.

Keywords: diagnosis; drug delivery system; exosomes; gliomas; treatment.

Figure A1

The flow diagram of study selection.

Figure 1

Strategies of exosomes for crossing the BBB. (A) Exosomes possess inherent BBB permeability. (B) Exosomes can hijack receptor-mediated transcytosis (RMT) by specific ligand-receptors binding to control transcytosis. (C) Exosomes can be modified with membrane-protein-binding peptides or neurotropic-virus-derived peptides to achieve effective delivery.

Figure 2

Roles of GDEs in glioma progression: (A) inducing changes in the tumor microenvironment; (B) mediating angiogenesis; (C) influencing proliferation and invasiveness of gliomas; (D) contributing to drug resistance; and (E) suppressing immune responses. It is important to note that the effects of active molecules on tumor progression are often not isolated but rather have a wide-ranging impact on various aspects of glioma development.