Figure 2.

The potential use of exosome-based therapies in cardiovascular diseases. Exosomes used as therapeutics are usually isolated from cell culture in vitro, which can be divided into naïve exosomes and drug-loaded exosomes that undergo artificial manipulation. Exosomes can be delivered into the body via intravenous (systemic) administration, oral administration, and intranasal administration, leading to different biodistributions and effects. When exosomes come into circulation, they first reach the liver and spleen where monocytes are located, and they may be recruited to infarcts or injury sites in the heart. Some naïve exosomes possess homing abilities, while others lack a unique target and can be improved by adding modifications. It has been reported that exosome-based therapies are safe overall, though further clinical trials are needed to test cardiovascular diseases. Generally, the promises of exosome-based therapeutics are huge, avoiding the difficulties that cellular therapies have, lowering manufacture costs, and increasing efficacy in treating diseases. However, certain obstacles need to be resolved such as purity and identity issues, inherent heterogeneity, and structural changes during manipulation.