ReviewDiagnostic and therapeutic potentials of exosomes in CNS diseases

•Exosomes are membrane-enveloped nanovesicles of endosomal origin.•They carry nucleic acids, proteins and lipids to nearby or distant cells.•Exosomal cargo regulates functions at target cells.•At least some exosomes recognize their targets in antigen specific manner.•Exosomes revolutionize the search for biomarkers and new therapies.

A newly discovered cell-to-cell communication system involves small, membrane-enveloped nanovesicles, called exosomes. We describe here how these extracellular nanoparticles were discovered and how it became gradually apparent that they play fundamental roles in regulation of physiological functions and pathological processes. Exosomes enable intercellular communication by transporting genetic material, proteins and lipids to cells in their vicinity or at distant sites, and subsequently regulating functions of targeted cells. Relatively recent experiments indicate that exosomes are released also by CNS cells, including cortical and hippocampal neurons, glial cells, astrocytes and oligodendrocytes, and that exosomes have significant impact on pathophysiology of the brain. How it is decided what individual exosomes will carry to their targets is not understood, but it appears that the contents may represent “signature cargos” that are characteristic for various conditions. Exploration of such characteristics could result in discovery of novel diagnostic biomarkers. Exosomes are also promising as a vehicle for therapeutic delivery of micro RNA or other compounds. How to deliver exosomes to selected sites has been a tantalizing question. Recent experiments revealed that at least some exosomes carry antibodies on their surface, suggesting that it may be feasible to deliver exosomes to unique sites based on the recognition of antigens by those antibodies. This discovery implies that rather precise targeting of both natural and engineered exosomes may be feasible. This would reduce distribution volume of therapeutics, and consequently minimize their side effects.This article is part of a Special Issue entitled Neuroimmunology in Health And Disease.