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Review
. 2022 Nov 17:13:1025348.
doi: 10.3389/fimmu.2022.1025348. eCollection 2022.

"Liquid biopsy" - extracellular vesicles as potential novel players towards precision medicine in asthma

Dominika Ambrożej  1   2 , Anna Stelmaszczyk-Emmel  3 , Małgorzata Czystowska-Kuźmicz  4 , Wojciech Feleszko  1
Affiliations
Review

"Liquid biopsy" - extracellular vesicles as potential novel players towards precision medicine in asthma

Dominika Ambrożej et al. Front Immunol. .

Abstract

Extracellular vesicles (EVs) have emerged as vital mediators in intracellular communication in the lung microenvironment. Environmental exposure to various triggers (e.g., viruses, allergens) stimulates the EV-mediated cascade of pro-inflammatory responses that play a key role in the asthma pathomechanism. This complex EV-mediated crosstalk in the asthmatic lung microenvironment occurs between different cell types, including airway epithelial cells and immune cells. The cargo composition of EVs mirrors hereby the type and activation status of the parent cell. Therefore, EVs collected in a noninvasive way (e.g., in nasal lavage, serum) could inform on the disease status as a "liquid biopsy", which is particularly important in the pediatric population. As a heterogeneous disease, asthma with its distinct endotypes and phenotypes requires more investigation to develop novel diagnostics and personalized case management. Filling these knowledge gaps may be facilitated by further EV research. Here, we summarize the contribution of EVs in the lung microenvironment as potential novel players towards precision medicine in the development of asthma. Although rapidly evolving, the EV field is still in its infancy. However, it is expected that a better understanding of the role of EVs in the asthma pathomechanism will open up new horizons for precision medicine diagnostic and therapeutic solutions.

Keywords: allergy; asthma; exosome; extracellular vesicle; inflammation; intercellular communication; microRNA; precision medicine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Schematic view of extracellular vesicles (EVs) as mediators of cellular interactions in the lung microenvironment. The complex EV-mediated crosstalk in the lung microenvironment occurs between many different cell types, including airway epithelial cells (AECs) and immune cells. Secreted EVs transfer specific cargo (e.g., proteins, miRNAs, mitochondria), which modulates the activity of target cells and can support tissue homeostasis or promote chronic respiratory changes. The exposure of airway epithelium to various environmental triggers (e.g., viruses, allergens) stimulates increased release of EVs with changed cargo composition that plays a critical role in asthma pathomechanism (including airway remodeling, airway hyperresponsiveness (AHR), mucus hypersecretion, increased lung inflammation). These EVs act in several ways (1): AEC-derived EVs target dendritic cells (DCs), macrophages, and themselves, promoting Th2- and Th17-polarized immune activation (2). DC-derived and B-cell-derived EVs can induce T-cell responses and serve as “antigen-presenting units” (3). T-cell-derived EVs cause Th2 skewing, eosinophil, neutrophil, and mast cell activation (4); that cells in turn produce EVs driving airway remodeling, and supply nitric oxide and reactive oxygen species, increasing the migration of other eosinophils and mast cells to the inflammation site (5). Macrophage-derived EVs also participate in airway remodeling, synthesizing leukotrienes and recruiting granulocytes to the inflammation site (6). In contrast, regulatory T cell (Treg)-derived EVs initiate anti-inflammatory activities. Created with BioRender.com.
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