Role of Extracellular Vesicles as Mediators of Cell Communication and Novel Biomarkers in Sepsis

Small extracellular vesicles (sEVs), typically <200 nm in diameter, have emerged as key mediators of intercellular communication, transferring bioactive molecules such as proteins, lipids, and nucleic acids between cells. This review focuses on the growing significance of sEVs in the context of sepsis, a life-threatening syndrome caused by a dysregulated immune response to infection. Sepsis remains a major global health challenge due to its complex pathophysiology, rapid progression, and the limitations of current diagnostic tools, which often fail to detect the condition early or accurately assess the host's immune status. As interest grows in precision diagnostics, sEVs have gained attention for their potential as biomarkers in liquid biopsy-a minimally invasive approach that analyzes circulating vesicles to monitor disease. Small EVs reflect the physiological state of their cells of origin and can provide real-time insights into immune activation, inflammation, and pathogen presence. This review explores the mechanisms by which sEVs contribute to immune modulation in sepsis, recent advances in understanding their biogenesis and uptake, and their diagnostic and prognostic potential. By highlighting the role of sEVs in sepsis, we aim to underscore their promise in improving early detection, guiding therapeutic decisions, and advancing personalized medicine.