Repici Alberto, Piraino Giovanna, Wolfe Vivian, Kaplan Jennifer, Nakamura Takahisa, Zingarelli Basilia
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy.
J Clin Med. 2025 Sep 21;14(18):6649. doi: 10.3390/jcm14186649.
Small extracellular vesicles (sEVs), typically <200 nm in diameter, have emerged as key mediators of intercellular communication, transferring bioactive molecules such as proteins, lipids, and nucleic acids between cells. This review focuses on the growing significance of sEVs in the context of sepsis, a life-threatening syndrome caused by a dysregulated immune response to infection. Sepsis remains a major global health challenge due to its complex pathophysiology, rapid progression, and the limitations of current diagnostic tools, which often fail to detect the condition early or accurately assess the host's immune status. As interest grows in precision diagnostics, sEVs have gained attention for their potential as biomarkers in liquid biopsy-a minimally invasive approach that analyzes circulating vesicles to monitor disease. Small EVs reflect the physiological state of their cells of origin and can provide real-time insights into immune activation, inflammation, and pathogen presence. This review explores the mechanisms by which sEVs contribute to immune modulation in sepsis, recent advances in understanding their biogenesis and uptake, and their diagnostic and prognostic potential. By highlighting the role of sEVs in sepsis, we aim to underscore their promise in improving early detection, guiding therapeutic decisions, and advancing personalized medicine.
小细胞外囊泡（sEVs），通常直径小于200纳米，已成为细胞间通讯的关键介质，在细胞之间传递蛋白质、脂质和核酸等生物活性分子。本综述重点关注sEVs在脓毒症背景下日益增长的重要性，脓毒症是一种由对感染的免疫反应失调引起的危及生命的综合征。由于其复杂的病理生理学、快速进展以及当前诊断工具的局限性，脓毒症仍然是一项重大的全球健康挑战，这些诊断工具往往无法早期检测到该病症或准确评估宿主的免疫状态。随着对精准诊断的兴趣增加，sEVs因其作为液体活检生物标志物的潜力而受到关注，液体活检是一种通过分析循环囊泡来监测疾病的微创方法。小细胞外囊泡反映了其起源细胞的生理状态，并能提供有关免疫激活、炎症和病原体存在的实时见解。本综述探讨了sEVs在脓毒症中促进免疫调节的机制、在理解其生物发生和摄取方面的最新进展以及它们的诊断和预后潜力。通过强调sEVs在脓毒症中的作用，我们旨在强调它们在改善早期检测、指导治疗决策和推进个性化医疗方面的前景。
