Autophagy and the endo/exosomal pathways in health and disease

Cell homeostasis requires the concerted action of cellular pathways involved in degradation, trafficking and intercellular communication, which are interlinked to satisfy the cell's needs upon demand. Defects in these pathways instigate the development of several age-related pathologies, such as neurodegenerative and chronic inflammatory diseases. Autophagy is an evolutionarily conserved and tightly regulated process of degrading cellular constituents. The endosomal and vesicular trafficking pathways contribute to this regulation and share common features with the autophagic process. Recently, autophagy has been implicated in the endosome/exosome secretory pathway. Importantly, current technological advances allow the manipulation of exosomes as drug nanocarriers in pharmaceutical intervention strategies. Here, we survey emerging findings relevant to the crosstalk between autophagy and the endo/exosomal vesicular trafficking pathways. In addition, we discuss novel methodologies that have recently been developed, which allow the utilization of these pathways for targeted drug delivery in disease.