Ghosh Subhrojyoti, Dey Anuvab, Chakrabarti Aneshwa, Bhuniya Tiyasa, Indu Neelparna, Hait Anirban, Chowdhury Ankita, Paul Aritra, Mahajan Atharva A, Papadakis Marios, Alexiou Athanasios, Jha Saurabh Kumar
Department of Biotechnology, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India.
Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India.
J Cell Mol Med. 2024 Dec;28(23):e70052. doi: 10.1111/jcmm.70052.
Leukaemia, a group of haematological malignancies, presents ongoing diagnosis, prognosis, and treatment challenges. A major obstacle in treating this disease is the development of drug resistance. Overcoming drug resistance poses a significant barrier to effective leukaemia treatment. The emergence of exosome research has unveiled new insights into the probable theragnostic implementations in leukaemia. Various research has exhibited the diagnostic possibilities of exosomes in identifying leukaemia-specific biomarkers, including genetic mutations and fusion transcripts. Additionally, exosomes have been implicated in disease progression and treatment response, rendering them appealing targets for therapeutics. Exosomes, originating from diverse cell types, are instrumental in intercellular communication as they participate in the functional transportation of molecules like proteins, nucleic acids and lipids across space. Exosomes have a dual role in immune regulation, mediating immune suppression and modulating anti-leukaemia immune responses. Interestingly, exosomes can even act as drug transport vehicles. This review delves into the intricate process of exosome biogenesis, shedding light on their formation and release from donor cells. The key mechanisms engaged in exosome biogenesis, for instance, the endosomal sorting complexes required for transport (ESCRT) machinery and ESCRT-independent pathways, are thoroughly discussed. Looking ahead, future approaches that leverage innovative technologies hold the promise of revolutionizing disease management and improving patient outcomes.
白血病是一组血液系统恶性肿瘤，在诊断、预后和治疗方面一直面临挑战。治疗这种疾病的一个主要障碍是耐药性的产生。克服耐药性是有效治疗白血病的重大障碍。外泌体研究的出现为白血病可能的诊疗应用带来了新的见解。各种研究已经展示了外泌体在识别白血病特异性生物标志物（包括基因突变和融合转录本）方面的诊断可能性。此外，外泌体与疾病进展和治疗反应有关，使其成为有吸引力的治疗靶点。外泌体源自多种细胞类型，通过参与蛋白质、核酸和脂质等分子在空间中的功能性运输，在细胞间通讯中发挥作用。外泌体在免疫调节中具有双重作用，介导免疫抑制并调节抗白血病免疫反应。有趣的是，外泌体甚至可以充当药物运输载体。本综述深入探讨了外泌体生物发生的复杂过程，阐明了它们从供体细胞的形成和释放。对外泌体生物发生中涉及的关键机制，例如运输所需的内体分选复合物（ESCRT）机制和不依赖ESCRT的途径，进行了全面讨论。展望未来，利用创新技术的未来方法有望彻底改变疾病管理并改善患者预后。
