Exosome-based drug delivery systems for the treatment of diabetes and its complications: current opinion

Abstract

Diabetes medication is based on controlling blood glucose and delaying the onset of related complications and is not a complete cure for diabetes. Conventional drug therapy fails to stop progressive islet β cell failure in diabetic patients. Recent studies have shown that "exosome-based therapy" holds great promise in treating diabetes and its complications. Exosomes are small vesicles that are stable in the bloodstream and can effectively deliver therapeutic drugs to specific tissues or organs through intercellular communication. Using exosomes as carriers for drug delivery offers several advantages. This review summarizes the benefits of exosomal drug delivery systems, drug loading methods, and their applications in treating diabetes and its complications. However, there are still challenges to overcome in using exosomal drug delivery systems, such as large-scale production, assessing the contents of exosomes, and monitoring the safety and effectiveness of the treatment in vivo. In conclusion, this review proposes the therapeutical potential of exosomes as drug carriers for developing novel drugs to provide new strategies for treating diabetes and its complications.

Keywords: Exosomes; diabetes; diabetic complications; drug carrier.

Figure 1

Biogenesis, structure, and action mode of the exosome. (A) Exosome formation is a function of endocytic membrane invagination and intraluminal vesicles (ILV) formation inside cells. Early maturation of endosomes leads to the formation of MVBs which are then delivered to lysosomes to be degraded or cross through microtubules to be combined with the plasma membrane and release exosomes into the extracellular space. (B) Exosomes contain various substances, such as mRNAs, miRNAs, proteins, enzymes, lipids, and carbohydrates. The exosome surface is decorated with various membrane proteins responsible for pathophysiological functions. (C) Exosomes facilitate communication between cells through three primary mechanisms. Signaling molecules act directly on the membrane's surface, regulate membrane fusion and its contents, and control the release of bioactive substances.

Figure 2

The advantages of exosome-based drug delivery therapy in diabetes mellitus and its complications. Exosome-based drug delivery systems can improve diabetic complications, including retinopathy, peripheral neuropathy, and delayed wound healing, by transporting drugs.