Introduction
Autoimmune diseases (AIDs) result from dysregulated immune responses against self-antigens, leading to chronic inflammation and tissue damage. Exosomes, as carriers of proteins, lipids, and nucleic acids, play crucial roles in intercellular communication in the immune system. Recent studies reveal their involvement in autoimmune pathogenesis and therapeutic potential.
Exosomes in Autoimmune Pathogenesis
- Antigen Presentation: Exosomes derived from antigen-presenting cells carry MHC molecules and co-stimulatory signals, influencing T cell activation [1].
- miRNA Transport: Autoimmune exosomes contain dysregulated microRNAs that modulate immune cell differentiation and cytokine secretion [2].
- Pro-Inflammatory Mediators: Exosomes from inflamed tissues carry cytokines such as TNF-α and IL-6, perpetuating inflammation.
Disease-Specific Findings
- Rheumatoid Arthritis (RA): Synovial fibroblast-derived exosomes promote joint inflammation by transferring pro-inflammatory mediators and matrix-degrading enzymes [3].
- Systemic Lupus Erythematosus (SLE): Circulating exosomes contain autoantigens and nucleic acids that trigger interferon responses, contributing to disease flares [4].
- Multiple Sclerosis (MS): Exosomal miRNAs influence blood-brain barrier integrity and neuroinflammation [5].
Therapeutic Applications
- Immunomodulatory Exosomes: MSC-derived exosomes suppress autoreactive T cells and induce regulatory T cells, ameliorating autoimmune symptoms in animal models [6].
- Drug Delivery Vehicles: Exosomes engineered to deliver anti-inflammatory drugs or siRNAs targeting pathogenic genes offer targeted therapy with reduced systemic effects.
- Biomarkers: Exosome profiling enables disease activity monitoring and treatment response assessment.
Challenges and Perspectives
- Standardizing isolation and characterization techniques.
- Understanding heterogeneity and disease-stage-specific exosome functions.
- Ensuring safety and efficacy in clinical applications.
Conclusion
Exosomes represent a promising frontier in autoimmune disease research, with potential to improve diagnosis and enable novel targeted therapies.
📚 References
- Théry C, et al. Exosomes: composition, biogenesis and function. Nat Rev Immunol. 2002;2(8):569-579. https://doi.org/10.1038/nri855
- Zhang X, et al. Exosomal miRNAs in autoimmune diseases: pathogenesis, biomarkers and therapeutic potential. Front Immunol. 2020;11:612812. https://doi.org/10.3389/fimmu.2020.612812
- Harnett MM, et al. Exosomes in rheumatoid arthritis: emerging mediators of inflammation and potential therapeutic targets. Nat Rev Rheumatol. 2020;16(4):213-222. https://doi.org/10.1038/s41584-020-0383-2
- Yu S, et al. Circulating exosomes serve as biomarkers and therapeutic targets in systemic lupus erythematosus. Cell Mol Immunol. 2019;16(10):932-943. https://doi.org/10.1038/s41423-019-0273-0
- Sáenz-Cuesta M, et al. Extracellular vesicles in multiple sclerosis: potential role as biomarkers and immunomodulators. Front Immunol. 2014;5:585. https://doi.org/10.3389/fimmu.2014.00585
- Wang Y, et al. MSC-derived exosomes as a novel therapeutic strategy for autoimmune diseases. Stem Cell Res Ther. 2021;12(1):218. https://doi.org/10.1186/s13287-021-02289-7