Exosome: a new avenue for endometriosis research

Exosome-mediated intracellular signaling impacts the development of endometriosis

Key Points

Highlight:

• In the context of endometriosis, exosome-mediated signaling could have a profound effect on disease progression.

Background:

• The pathophysiology of the endometriosis remains enigmatic.
• Recent studies have shown a strong correlation between the etiology of endometriosis and immune dysregulation in endometriosis patients.
• Exosomes, range in size from 30 to 100 nm in diameter, are a unique subset of extracellular vesicles that mediate cell to cell communication by trafficking distinct signaling factors.
• Studies characterizing the role of exosomes have advanced our understanding of the etiology of various diseases including inflammatory conditions, neurological diseases, immune-related disorders, and cancer.
• Here, Dr. Hull group from Australia discuss recent manuscripts that explore the role of exosomes in endometriosis and the impact they may have on immune function.

Key points:

• Early studies of exosomes in endometriosis focused on their potential utility as biomarkers of disease.
• Recently, exosomes from ovarian endometrioma patients showed high levels of ecto-nucleotidases that regulate extracellular ATP level, therefore, may contribute to progression by diminishing the immune response.
• More recently, the therapeutic use of exosomes (such as delivery of miR-214-enriched exosomes) to modulate endometriotic lesion development has been explored.
• Other studies have drawn links between exosomes and immune function in endometriosis, especially in macrophage communication.
• Based on Drs. Ismail and Zhuang studies, miR-223, which is the most abundant miRNA in macrophage-derived exosomes and dysregulated in endometriosis patients, plays a pivotal role in enhancing alternative M2-like macrophage.
• To assess their molecular mechanisms, future studies should examine the composition of exosomes as well as develop models.
• Importantly, studies examining whether targeted therapeutic approaches can attenuate exosome composition and constrain lesion development may improve quality of life for the many women with this chronic debilitating condition.

Lay Summary

Endometriosis affects 10% of reproductive-aged women. The pathophysiology of this disease remains mysterious, with a lack of effective biomarkers necessitating surgical intervention for diagnosis. This creates an urgent need for accurate noninvasive diagnostic tests and the identification of effective therapeutic targets to improve clinical outcomes for women with endometriosis.

Recent studies have shown a strong correlation between the etiology of endometriosis and immune dysregulation in endometriosis patients. Exosomes, range in size from 30 to 100 nm in diameter, are a unique subset of extracellular vesicles that mediate cell to cell communication by trafficking distinct signaling factors, including nucleic acids, proteins, lipids, and cytokines. Studies characterizing the role of exosomes have advanced our understanding of the etiology of various diseases including inflammatory conditions, neurological diseases, immune-related disorders, and cancer.

Here, Dr. Hull group from Australia discuss recent manuscripts that explore the role of exosomes in endometriosis and the impact they may have on immune function. The paper is published in the journal "Molecular Human Reproduction".

Early studies of exosomes in endometriosis focused on their potential utility as biomarkers of disease. Recently, exosomes isolated from ovarian endometrioma aspirates of endometriosis patients express high levels of ecto-nucleotidases which contribute to immune modulation by regulating extracellular ATP and rising extracellular adenosine levels, and may, therefore, contribute to disease progression by attenuating the immune response. More recently, the therapeutic use of exosomes (such as delivery of miR-214-enriched exosomes) to modulate endometriotic lesion development has been explored. Other studies have drawn links between exosomes and immune function in endometriosis, especially in macrophage communication. Based on Drs. Ismail and Zhuang studies, miR-223, which is the most abundant miRNA in macrophage-derived exosomes and dysregulated in endometriosis patients, plays a pivotal role in enhancing alternative M2-like macrophage.

To assess their molecular mechanisms, future studies should examine the composition of exosomes as well as develop models. Importantly, studies examining whether targeted therapeutic approaches can attenuate exosome composition and constrain lesion development may improve quality of life for the many women with this chronic debilitating condition.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/?term=30445586