Exosome Based Biomarkers as Diagnostic Tool in Cardiovascular Diseases

Recent studies indicate that exosome structures depend on the condition of the original cells at the time of exosomes' biological generation. During this process, signaling proteins, RNAs or other molecules expressed in the mother cells can be selectively loaded into exosomes, although the specific mechanisms are still out of reach. In laboratory experiments indicated that the biological contents of exosomes depend on treatment with different stressors. De Jong et al. It was shown that in exosomes derived from endothelial cells, RNA and protein content reflects the effects of cellular stress caused by hypoxia, inflammation or hyperglycemia. Stimulated hypoxia-induced expression to remove oxidase-like 2 and TNF-α-therapy enhanced ICAM-1 expression in exosomes. In the short term, exposure to hyperglycemia only changes the composition of the exosome protein without affecting RNA expression.

In experimental conditions of myocardial injury conditions, increasing evidence shows that both the contents and quantities of exosomes show important changes. Chen et al. It was shown that miRNA 451 enriched in exosomes of CPCs showed anti-apoptosis effects in ischemic heart muscle damage. Deddens and colleagues evaluated EVs and traded miRNAs in a pig model for ischemic / pumping injury, indicating that the amount of EVs increased 2.5 hours after ischemia. However, changes in circulating Myrna levels were only discoverable after 1 hour. Additionally, they found that miRNA-133b, -208b, and -499 were selectively increased in plasma-derived EVs. Since the formation of exosome reflects the state of the absolute cell, it provides a biological illustration of the individual health condition. Therefore, exosomes can be considered a potential footprint of disease.

Exosomes contain vital molecules and can be secreted through different types of cells in body fluids, for example plasma, urine, semen and breast milk. Since exosomes consist of a lipid bilayer, they represent an effective protective barrier for molecules within the ureter. For example, because of enzymes in plasma or other body fluids, RNA or protective proteins may easily degrade, leading to unstable results. Exosomes, with the help of the vesicle structure, protect their contents from exposure to external environments. Consequently, previous studies have shown correlations between exosomes of biological contents and various cardiovascular diseases, which is a prerequisite for biomarkers. In short, considering its function as a carrier and protective device for intravenous biological contents, growing evidence points to exosomes and their contents as reliable biological markers for cardiovascular disease.

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The contents and quantities of exosomes are variable under different pathological cardiovascular conditions. Therefore, exosomes may act as new diagnostic biomarkers. Exosomes including miRNAs and proteins are the most widely investigated components. In addition, other charges such as fats can also act as potential biomarkers. Extracellular circulating miRNAs can be detected in body fluids, including blood. Moreover, exosomes and other EVs are the main source for the rotation of miRNAs. Compared to freely circulating miRNA, the majority of miRNA plasma is concentrated in exosomes and bound to RNA binding proteins. Therefore, miRNAs with exosomes carry great potential as a new diagnostic biological sign for heart disease. However, the investigation of exosomal miRNAs as vital signs of heart disease is still in its infancy. In the following paragraphs, we summarize current knowledge about miRNAs incorporated into exosomes as diagnostic biological markers in various cardiovascular diseases.

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