Small Extracellular Vesicles in Alcohol Use Disorders: A Scoping Review

Alcohol consumption is one of the most significant global public health challenges. The pathophysiology of alcohol use disorder remains only partially elucidated, and direct biomarkers for this disorder have yet to be identified. Some studies have investigated the profiles of small extracellular vesicles (sEVs) in different bodily fluids. However, the findings across these studies are heterogeneous, and the methodological quality of these studies has not been systematically assessed.

To summarize the results of studies examining the sEVs' profiles in alcohol use disorders.

The review included original research articles that explored the sEVs' profiles in alcohol use disorders. The MEDLINE (for studies published up to November 2025) and Scopus (for studies published up to January 10, 2026) were searched. The analysis of the included studies was conducted using a descriptive evidence synthesis approach based on the categories of lipid profile, protein profile, and signaling molecules. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) adapted for extracellular vesicle research.

Ten studies were included. All studies employed a cross-sectional design, were conducted in small cohorts, and included patients with acute and chronic alcohol intoxication, as well as those with alcohol use disorder. Significant differences in the sEVs' profiles were identified in individuals with alcohol use disorders compared to healthy controls. These differences encompassed modifications in lipid and protein profiles, decreased expression of hsa-miR-144-5p, hsa-miR-182-5p, hsa-miR-142-5p, hsa-miR-7-5p, hsa-miR-15b-5p, and hsa-circ-0004771, an increased expression of miR-30a-5p and miR-194-5p, as well as alterations in inflammatory response parameters. The majority of these differences were related to the regulation of inflammation.

In alcohol use disorders, sEVs differ in lipid and protein profiles as well as in microRNA expression. New studies are needed to investigate the impact of sEVs on the regulation of systemic inflammation in alcohol use disorders using a prospective design with repeated measurements of specific sEV characteristics.