مقالات پذیرفته شده در هشتمین کنگره بین المللی زیست پزشکی
Exploring the Therapeutic Potential of Exosomes in the Fight Against Cancer
Exploring the Therapeutic Potential of Exosomes in the Fight Against Cancer
Haniye Fayezi,1,*
1. M.sc of Pathogenic Microbes Islamic Azad University North Tehran Branch, Tehran Iran
Introduction: Over the last few decades, astronomical amounts of research funding and efforts have been invested in cancer research, with a primary aim of understanding and eradicating cancer. Cancer remains the second most prevalent cause of death worldwide despite the significant progress made in discovering new diagnostic, therapeutic, and preventive techniques over the past 40 years. While research has demonstrated that genetic mutations are the primary cause of carcinogenesis and cancer progression, there is limited knowledge about the causes or mechanisms behind their occurrence and progress. Exosomes are a class of extracellular vesicles approximately 100 nm in diameter, secreted by most cells and contain various bioactive molecules reflecting their cellular origin and the function of intercellular communication. The development of therapeutic and diagnostic approaches using exosomes for the treatment of cancer has resulted from studies on these exosomal features in tumor pathogenesis. Exosomes have a number of advantages for the transmission of therapeutic agents such as small interfering RNAs, microRNAs, membrane associated proteins and chemotherapeutic compounds; therefore, they are considered to be a potential delivery tool for cancer therapy. The use of exosomes to activate specific immune stages of cancer has led to the creation of bioactive molecules that act as cancer immunotherapies, as they provide an optimal microenvironment for immunomodulatory factors. The benefits of exosomes for cancer treatment and the challenges that need to be overcome in developing them are discussed in this review article.
Methods: Exosomes, between macromolecules and cells, can be classified as organelles that are becoming more widely known for their diagnostic qualities and therapeutic applications. Exosomes are considered to be an appropriate tool for the treatment of a variety of diseases, including cancer, since they contain molecules with different functions but lack their complexity in cells and tissues; unlike proteins or small molecules. Furthermore, exosomes offer a number of advantages in terms of biocompatibility, immunogenicity, stability, pharmacokinetics, biodistribution and cell uptake mechanism which make them candidates for anticancer treatment. These characteristics can lead to an improvement in the therapy index for exosomes based cancer treatments, through preferential treatment of tumor cells while avoiding side effects that are unpredictable.
Results: The purpose of this review was to highlight the usefulness and potential of exosomes in cancer therapy. Until recently, cancer treatment has relied mainly on physical surgery, chemotherapy, target therapy, or radiotherapy; however, these therapeutic modalities are commonly accompanied by side effects, acquired resistance, frequent metastasis, and recurrences. Cancer immunotherapy has emerged as a promising alternative to these conventional therapies to treat a variety of malignancies and has demonstrated remarkable clinical results, gaining considerable attention as a next-generation cancer treatment. Recently, with the popularity of proteomics analyses, the secretion and function of exosomal proteins obtained from cell lines or body fluids have been revealed, and more attention has been given to their role in predicting tumor development. Exosomal surface proteins hold clues to the mechanisms of exosome biogenesis, secretion, protein‒protein interactions, and recipient cell targeting. exosomal proteins play essential roles in many aspects of cancer, including EMT, ECM remodeling, angiogenesis, tumor-related immune regulation, premetastatic behavior, and therapeutic resistance. The characteristic proteins of cancer lesions are concentrated in the exosomes from human body fluids. Exosomal surface biomarkers have been detected, indicating that the identification of exosomal surface biomarkers may provide biological information on tumours, using known cancer surface marker antibodies attached to a chip. New biomarkers will be identified for early cancer diagnosis, prognosis and treatment assessment with more sensitive methods to be developed.
Conclusion: All over the world, exosomes are being studied and developed. In addition, to develop medicinal products based on exosomes a number of studies have been carried out both in vitro and in vivo as well as at the laboratory level. Despite various studies conducted on cancer treatment, cancer remains the leading cause of death globally. Chemotherapy, targeted therapy, and ICI have not effectively controlled cancer progression. Because chemotherapy has multiple side effects, targeted therapy has a limited indication, and ICI has a low response rate, better cancer treatment strategies are needed.ICI's low response rate is often improved by ex vivo immunotherapies.By using it as a means of chemotherapy, it can decrease the side effects of conventional chemotherapy and improve its effectiveness. However, because exosomes, particularly tumor-released exosomes, have a pro-tumorigenic proclivity and show excessive immune responses, further studies on their pro-tumorigenic and anti-tumorigenic functions are required. It is essential to establish a gold standard for a large scale, scalable manufacturing process to produce and purify exosomes for clinical trials. Despite a number of challenges, exosomes have great potential for drug development and delivery in the treatment of cancer.