Introduction
Extracellular vesicles (EVs) encompass a heterogeneous group of particles secreted permanently by virtually all cells. They are present in a number of biofluids and transfer information from the cell of origin to recipient cells by carrying various bioactive molecules, including proteins, lipids, metabolites, and nucleic acids (Kalluri and LeBleu 2020). The extensive body of literature indexed in PubMed underscores the abundant research interest in EVs, with over forty-four thousand records, comprising original research and reviews, as of April 2024. Within this corpus, a notable subset explores the potential utilization of EVs as diagnostic and therapeutic agents across a variety of diseases (Kumar et al., 2024).
The term ‘cardiovascular disease’ (CVD) encompasses a group of diseases affecting the heart and blood vessels, including coronary heart disease, cerebrovascular disease, peripheral arterial disease, hypertensive heart disease, heart failure, cardiomyopathy, and other conditions. CVD is the leading cause of death worldwide (Tsao, 2022), making the diagnosis, prevention, and effective therapy of CVD a focus of interest. Despite significant advancements in this field, an intensive search continues for new biomarkers that enable early and precise diagnosis of CVD risk and adverse outcomes, to guide personalized treatment, as well as for new therapeutic targets and more effective therapeutic methods. In studies exploring new biomarkers and in those investigating novel CVD therapies, extracellular vesicles receive considerable attention (Sahoo et al., 2021, Martin-Ventura et al., 2022, Du et al., 2023, Kim et al., 2023, Olejarz et al., 2024).
An overview of publications in this area – including both original papers and reviews summarising findings from human and experimental animal studies – underscores the substantial diagnostic and therapeutic potential of EVs for CVD. However, neither the professional literature nor databases intended for clinicians provide any information on the principles of using EVs in clinical practice. Therefore, this paper aims to interrogate the available data and identify what is needed to translate the underlying potential of EVs into specific EV-biomarkers and EV-therapeutic tools which could be applicable in clinical practice.