Renu Kaviyarasi
Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, Tamil Nadu, India.
J Cardiovasc Transl Res. 2025 Jul 7. doi: 10.1007/s12265-025-10655-6.
Diabetic cardiomyopathy (DCM), defined as cardiac impairment resulting from the development of diabetes mellitus, has emerged as a global epidemic. DCM primarily denotes myocardial metabolic impairment induced by elevated glucose levels, with hyperglycemia serving as a separate risk factor for heart disease in a lack of hypertension and coronary atherosclerosis. Exosomes, a category of tiny extracellular vesicles essential for communication between cells, have attracted considerable interest for their prospective use in the investigation and management of DCM. Exosomes harbour bioactive chemicals that indicate specific physiological conditions, modulate bioenergetic metabolism, and facilitate tissue healing. This review elucidates the dynamic progression of exosome research in DCM through bioenergetic disruptions, encompassing different processes such as endothelial dysfunction, mitochondrial impairment, calcium signalling in the endoplasmic reticulum, cell death including apoptosis and ferroptosis, inflammation-related fibrosis, autophagy, and hypertrophy. It emphasizes the necessity for continued research to fully exploit the potential of exosomes in enhancing patient outcomes.
糖尿病性心肌病（DCM）被定义为糖尿病发展导致的心脏损害，已成为一种全球性的流行病。DCM主要指由血糖水平升高引起的心肌代谢损害，在没有高血压和冠状动脉粥样硬化的情况下，高血糖是心脏病的一个独立危险因素。外泌体是一类对细胞间通讯至关重要的微小细胞外囊泡，因其在DCM研究和管理中的潜在用途而备受关注。外泌体含有指示特定生理状况、调节生物能量代谢和促进组织愈合的生物活性化学物质。本综述通过生物能量紊乱阐明了外泌体在DCM研究中的动态进展，包括内皮功能障碍、线粒体损伤、内质网钙信号传导、细胞死亡（包括凋亡和铁死亡）、炎症相关纤维化、自噬和肥大等不同过程。它强调了持续研究以充分发挥外泌体在改善患者预后方面潜力的必要性。
