Extracellular vesicles and cellular communication : emerging roles in disease progression and therapy
Year: 2026
Type: dissertation
Abstract: Background: Extracellular vesicles (EVs)—including exosomes, microvesicles, and apoptotic bodies—have emerged as central mediators of cell-to-cell communication, replacing historical paradigms that dismissed them as inert cellular waste. This review synthesizes the molecular biology, biogenesis, cargo-sorting mechanisms, and multi-scale communication networks of EVs, outlining their critical roles in human physiology and disease progression. Methods and Findings: Synthesized data across oncology, neurology, immunology, and cardiovascular medicine reveals that EVs are selectively packaged with proteins, non-coding RNAs, lipids, and metabolites. In healthy states, EVs regulate tissue homeostasis, stem cell niches, and immune tolerance. Conversely, progressive pathologies hijack these pathways: tumor-derived EVs orchestrate pre-metastatic niche formation and immunosuppression; neural EVs propagate neurotoxic aggregates via prion-like seeding; cardiovascular EVs accelerate endothelial injury and thrombotic risk; and microbial EVs facilitate pathogen subversion and antimicrobial resistance. Furthermore, this review evaluates the clinical translation of EVs as high-fidelity liquid biopsy biomarkers and surface-engineered, biocompatible nanocarriers for targeted drug delivery across challenging anatomical barriers. Conclusions: Although EV platforms hold transformative promise for precision medicine, critical translation bottlenecks remain. Methodological fragmentation in mass isolation, subpopulation physical heterogeneity, unmapped cargo sorting motifs, large-scale GMP-compliant manufacturing barriers, and ambiguous international regulatory classifications must be systematically solved. Future advancements depend on combining high-throughput multi-omics with artificial intelligence analytics and wearable biosensors to map continuous patient-specific molecular networks. Ultimately, coordinated global interdisciplinary collaboration is required to transition laboratory-bench EV innovations into safe, standardized, and clinically effective cellular therapies.
Author: Kashyap, Siddhant
Language: English
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W7222855682