To the Future: The Role of Exosome-Derived microRNAs as Markers, Mediators, and Therapies for Endothelial Dysfunction
Maurice B Fluitt1, Neal Mohit1,2, Kanwal K Gambhir1
1Division of Endocrinology and Metabolism, Department of Medicine, Howard University College of Medicine, 520 W St NW, Washington, DC 20059, USA.
Abstract:
The prevalence of diabetes mellitus (DM) is increasing at a staggering rate around the world. In the United States, more than 30.3 million Americans have DM. Type 2 diabetes mellitus (T2DM) accounts for 91.2% of diabetic cases and disproportionately affects African Americans and Hispanics. T2DM is a major risk factor for cardiovascular disease (CVD) and is the leading cause of morbidity and mortality among diabetic patients. While significant advances in T2DM treatment have been made, intensive glucose control has failed to reduce the development of macro and microvascular related deaths in this group. This highlights the need to further elucidate the underlying molecular mechanisms contributing to CVD in the setting of T2DM. Endothelial dysfunction (ED) plays an important role in the development of diabetes-induced vascular complications, including CVD and diabetic nephropathy (DN). Thus, the endothelium provides a lucrative means to investigate the molecular events involved in the development of vascular complications associated with T2DM. microRNAs (miRNA) participate in numerous cellular responses, including mediating messages in vascular homeostasis. Exosomes are small extracellular vesicles (40-160 nanometers) that are abundant in circulation and can deliver various molecules, including miRNAs, from donor to recipient cells to facilitate cell-to-cell communication. Endothelial cells are in constant contact with exosomes (and exosomal content) that can induce a functional response. This review discusses the modulatory role of exosomal miRNAs and proteins in diabetes-induced endothelial dysfunction, highlighting the significance of miRNAs as markers, mediators, and potential therapeutic interventions to ameliorate ED in this patient group.
Insights
Type 2 diabetes mellitus (T2DM) accelerates cardiovascular disease (CVD) by causing endothelial dysfunction. Exosomal microRNAs (miRNAs) are key mediators, offering potential as biomarkers and therapeutic targets for T2DM-related vascular complications.
Area of Science:
- Molecular Biology
- Cardiovascular Research
- Endocrinology
Background:
- Diabetes mellitus (DM), particularly Type 2 diabetes mellitus (T2DM), is a global health crisis with rising prevalence.
- T2DM significantly increases the risk of cardiovascular disease (CVD), a leading cause of death, and is linked to endothelial dysfunction (ED).
- Current intensive glucose control strategies have not fully mitigated macro- and microvascular complications in T2DM patients, necessitating deeper mechanistic understanding.
Purpose of the Study:
- To review the role of exosomal microRNAs (miRNAs) and proteins in mediating endothelial dysfunction in the context of T2DM.
- To highlight the potential of exosomal miRNAs as diagnostic markers, disease mediators, and therapeutic targets for T2DM-associated vascular complications.
Main Methods:
- Literature review focusing on the molecular mechanisms of endothelial dysfunction in T2DM.
- Analysis of the role of exosomes and exosomal miRNAs in intercellular communication within the vascular system.
- Discussion of current research on exosomal content in diabetes-induced vascular complications.
Main Results:
- Exosomes, particularly their miRNA cargo, play a significant role in facilitating cell-to-cell communication and modulating endothelial cell function.
- Exosomal miRNAs are implicated in the development and progression of diabetes-induced endothelial dysfunction.
- Specific exosomal miRNAs show potential as biomarkers for early detection and as therapeutic agents to combat T2DM-related vascular damage.
Conclusions:
- Exosomal miRNAs are critical players in the pathogenesis of endothelial dysfunction associated with T2DM.
- Targeting exosomal miRNAs presents a promising avenue for developing novel diagnostic tools and therapeutic strategies for T2DM cardiovascular complications.
- Further research into exosomal miRNA function is essential for ameliorating endothelial dysfunction and improving outcomes in diabetic patients.
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