Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 May 16;23(1):553.
doi: 10.1186/s12967-025-06522-2.

Diagnostic and prognostic roles of endothelial- and platelet-derived extracellular vesicles in cardiovascular diseases

Riccardo Di Febo  1 , Zeeba Saeed  2   3 , Francesco Serafini  4 , Davide Brocco  2   3 , Francesca D'Ascanio  3   5 , Andrea Delli Pizzi  6   7 , Nicola Tinari  2   3 , Rossella Crescitelli  8 , Paola Lanuti  3   9 , Giulia Renda  10   11
Affiliations
Review

Diagnostic and prognostic roles of endothelial- and platelet-derived extracellular vesicles in cardiovascular diseases

Riccardo Di Febo et al. J Transl Med. .

Abstract

Extracellular vesicles (EVs) are membrane-bound structures released by all cell types. They play a critical role in intercellular communication by transferring their cargo, comprising proteins, lipids, metabolites, RNAs, miRNAs, and DNA fragments, to recipient cells. This transfer influences gene expression, signaling pathways, and cellular behavior. Due to their ability to alter the physiology of recipient cells, EVs hold significant therapeutic potential. Additionally, EVs are implicated in various physiological and pathological processes, including immune regulation, cancer progression, and cardiovascular diseases. EVs have been detected in many biological fluids, such as peripheral blood, saliva, urine, cerebrospinal fluid, and breast milk. The cargo of EVs dynamically reflects the physiological and pathological state of their parent cells, making them promising candidates for liquid biopsies in various clinical conditions. Specifically, different EV subtypes in cardiovascular diseases have been studied, with both endothelial and platelet-derived EVs playing significant roles in cardiovascular pathologies. This review focuses on the diagnostic and prognostic potential of endothelial and platelet-derived EVs in cardiovascular diseases, highlighting the role of EV subpopulations.

Keywords: Cardiovascular diseases; Endothelial-derived extracellular vesicles; Extracellular vesicles; Platelet-derived extracellular vesicles.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable (review). Consent for publication: Not applicable (review). Competing interests: RC has developed multiple EV-associated patents for putative clinical utilization: US20200088734 A1, United States; WO2020146390 A1, WIPO (PCT). RC owns equity in Exocure Bioscience Inc. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Extracellular vesicles (EVs) biogenesis. Mechanisms of extracellular vesicle release and EV markers. ALIX ALG-2-interacting protein X, CD cluster of differentiation, ESCRT endosomal sorting complex required for transport, HRS hepatocyte growth factor-regulated tyrosine kinase substrate, HSP heat shock protein, ILVs intraluminal vesicles, MHC major histocompatibility complex, MVB multivesicular bodies, sEVs soluble extracellular vesicles, TSG101 tumor susceptibility gene 101 protein
Fig. 2
Fig. 2
Impact of PCSK9 on cardiovascular risk via EV release. PCSK9 expression induces a pro-inflammatory state through the activation of platelets, macrophages, and endothelial cells mediated by the release of EVs. PCSK9 proprotein convertase subtilisin/kexin type 9, IL interleukin. Created with Biorender.com
Fig. 3
Fig. 3
Role of platelet and endothelial-derived EVs in arterial inflammation and atherosclerosis. Summary of proinflammatory and anti-inflammatory effects mediated by EVs on vascular, endothelial, and immune cells in atherosclerosis. ICAM-1 intercellular ddhesion molecule 1, IL interleukin, EVs extracellular vesicles. Created with Biorender.com
Fig. 4
Fig. 4
miRNA in endothelial-derived EVs circulating in obese patients. EVs show a specific miRNA signature in the obesity state. Mir miRNA. Created with Biorender.com
Fig. 5
Fig. 5
Endothelial-derived EVs and endothelial activation in type 2 diabetes mellitus. Mechanisms of endothelial dysfunction and inflammation promoted by EVs in diabetic patients. IgG immunoglobulin G, NO nitric oxide, TGF-β trasforming growth factor beta. Created with Biorender.com
See this image and copyright information in PMC

References

    1. Simeone P, Bologna G, Lanuti P, et al. Extracellular vesicles as signaling mediators and disease biomarkers across biological barriers. Int J Mol Sci. 2020. 10.3390/ijms21072514. - PMC - PubMed
    1. Buca D, Bologna G, D’Amico A, et al. Extracellular vesicles in feto-maternal crosstalk and pregnancy disorders. Int J Mol Sci. 2020. 10.3390/ijms21062120. - PMC - PubMed
    1. Franzago M, Lanuti P, Fraticelli F, et al. Biological insight into the extracellular vesicles in women with and without gestational diabetes. J Endocrinol Invest. 2021;44(1):49–61. 10.1007/s40618-020-01262-0. - PubMed
    1. Brocco D, De Bellis D, Di Marino P, et al. High blood concentration of leukocyte-derived extracellular vesicles is predictive of favorable clinical outcomes in patients with pancreatic cancer: results from a multicenter prospective study. Cancers (Basel). 2022. 10.3390/cancers14194748. - PMC - PubMed
    1. Pagotto S, Simeone P, Brocco D, et al. CAR-T-derived extracellular vesicles: a promising development of CAR-T anti-tumor therapy. Cancers (Basel). 2023. 10.3390/cancers15041052. - PMC - PubMed

LinkOut - more resources