Overview of exosomal non-coding RNAs in cardiovascular disease using high throughput sequencing

Non-coding RNAs including miRNAs, long-ncRNAs, and circular RNAs play crucial roles in cell-to-cell communication and epigenetic regulation. They control gene expression at multiple levels, including transcriptional, post-transcriptional, and translational, thereby influencing associated signaling pathways. Encapsulated within exosomes, micro-vesicles, and apoptotic bodies, ncRNAs can be transported between cells while being protected from harsh environmental conditions. Studies have shown various expression patterns across different cell types and in various physiological and pathological states. However, the precise correlations and extent of their contribution to diseases are still under investigation. Recent studies have reported the involvement of extracellular vesicle-associated ncRNAs in the pathogenesis of cardiovascular diseases, such as hypertension. This involvement has been linked to the regulation of a range of cellular and molecular pathways, including the renin-angiotensin system. Because these exosomes can be stably detected and measured in body fluids, they hold promise as tools for both diagnosis and therapy. This review explores the potential diagnostic utility of cell-derived circulating extracellular vesicle ncRNA-based biomarkers and therapeutic approaches in cardiovascular diseases, utilizing the Next-Generation Sequencing techniques. Additionally, we address significant challenges, recent advancements, and prospects of extracellular vesicle biomarkers, with a focus on their clinical applications in the context of cardiovascular diseases and hypertension.