Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.
Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.
J Physiol. 2023 Nov;601(22):4837-4852. doi: 10.1113/JP282048. Epub 2022 Apr 12.
Cardiovascular diseases (CVDs), which encompass a myriad of pathological conditions that affect the heart and/or the blood vessels, remain the major cause of morbidity and mortality worldwide. By transferring a wide variety of bioactive molecules, including proteins and microRNAs (miRNAs), extracellular vesicles (EVs) are recognized as key players in long-range communication across the cardiovascular system. It has been demonstrated that these highly heterogeneous nanosized vesicles participate both in the maintenance of homeostasis of the heart and vessels, and contribute to the pathophysiology of CVDs, thus emerging as promising tools for diagnosis, prognosis and treatment of multiple CVDs. In this review, we highlight the beneficial roles of EV-mediated communication in regulating vascular homeostasis, and inter-organ crosstalk as a potential mechanism controlling systemic metabolic fitness. In addition, the impact of EV secretion in disease development is described, particularly focusing on cardiac remodelling following ischaemia, atherogenesis and atrial fibrillation progression. Finally, we discuss the potential of endogenous and bioengineered EVs as therapeutic tools for CVDs, as well as the suitability of assessing the molecular signature of circulating EVs as a non-invasive predictive marker of CVD onset and progression. This rapidly expanding field of research has established the role of EVs as key conveyors of both cardioprotective and detrimental signals, which might be of relevance in uncovering novel therapeutic targets and biomarkers of CVDs.
心血管疾病（CVDs）包括影响心脏和/或血管的多种病理状况，是全球发病率和死亡率的主要原因。细胞外囊泡（EVs）作为在心血管系统内进行长距离通讯的关键介质，可以转移多种生物活性分子，包括蛋白质和 microRNAs（miRNAs）。已经证明，这些高度异质的纳米级囊泡不仅参与了心脏和血管的稳态维持，而且还参与了 CVD 的病理生理学过程，因此它们有望成为多种 CVD 的诊断、预后和治疗的工具。在这篇综述中，我们强调了 EV 介导的通讯在调节血管稳态和器官间串扰方面的有益作用，后者可能是控制全身代谢适应性的潜在机制。此外，还描述了 EV 分泌在疾病发展中的作用，特别是聚焦于缺血后心脏重构、动脉粥样硬化和心房颤动进展。最后，我们讨论了内源性和生物工程 EV 作为 CVD 治疗工具的潜力，以及评估循环 EV 分子特征作为 CVD 发病和进展的非侵入性预测标志物的适宜性。这个快速发展的研究领域已经确立了 EV 作为心脏保护和有害信号的关键传递者的作用，这可能有助于揭示 CVD 的新治疗靶点和生物标志物。
