Extracellular vesicles in clinical chemistry: A focus on biomarkers

Extracellular vesicles (EVs) are nanoscale particles released by cells into body fluids and serve as crucial mediators of intercellular communication. This chapter explores their biogenesis, cargo composition, and biological functions on target cells. It discusses the diverse molecular cargo of EVs that includes lipids, proteins, and nucleic acid and focuses on their sorting, analysis, and functional significance. It highlights their importance as biomarkers as diagnostic and prognostic tools, particularly their potential application in clinical chemistry. The chapter also provides an overview of the current techniques for isolating and characterizing EVs from various body fluids and recent technological advancements. It compares EV and liquid biopsy biomarkers, outlines their advantages and limitations, and examines their translational impact on personalized medicine. Furthermore, this chapter emphasizes the clinical relevance of EV biomarkers, especially in monitoring aging, evaluating anti-aging therapy, and diagnosing age-related diseases such as neurodegenerative, cardiovascular, and musculoskeletal disorders. The chapter concludes with a critical discussion about the potential of EV research to revolutionize clinical diagnostics, which unfortunately remains constrained by regulatory hurdles and a lack of standardization.