Adipose-Derived Exosomes: mediators of crosstalk between Adipose tissue and cancer

Abstract

Adipose-derived exosomes (ADEs), a subtype of extracellular vesicles, are critical mediators of communication between adipose tissue and tumors, playing pivotal roles in cancer progression and therapeutic response. These nanoscale vesicles carry microRNAs, proteins, and lipids that influence tumor cell proliferation, migration, metastasis, and immune modulation. The dual functions of ADEs - both in promoting and suppressing tumorigenesis - are largely dependent on their cellular origin, molecular cargo, and the characteristics of the tumor microenvironment. Recent studies have identified ADEs as potential diagnostic biomarkers, therapeutic targets, and drug delivery platforms, offering promising avenues for precision oncology. However, significant challenges - such as biological heterogeneity, lack of standardization in production, concerns regarding efficacy and safety, and regulatory constraints - continue to hinder their clinical translation. This review aimed to explore the multifaceted roles of ADEs in cancer pathogenesis, their therapeutic potential, and current limitations, providing insights to guide future research and clinical applications.

Keywords: Adipose-derived exosomes; adipose tissue; cancer; exosome-based therapy; miRNA; tumor microenvironment.

Figure 1.

Schematic representation of exosome biogenesis showing key molecular pathways involved in exosome formation, including the ESCRT-dependent and ESCRT-independent mechanisms, Rab GTPase regulation, and SNARE-mediated release.

Figure 2.

Schematic representation of the tumor microenvironment, illustrating various cellular components, including cancer cells, cancer stem cells, fibroblasts, endothelial cells, lymphocytes, and tumor-associated macrophages.

Figure 3.

Key determinants of ADE functional variability in cancer. This schematic illustrates the principal biological parameters that collectively modulate the tumor-modulating roles of adipose-derived exosomes, including the anatomical origin of adipose depots, the metabolic condition of the donor, tumor characteristics, exosomal molecular cargo, and the signaling pathways activated in recipient cells. These interdependent factors determine whether ADEs exert tumor-promoting or tumor-suppressive effects within a given oncological context.