According to the World Health Organization, at least 2.2 billion people worldwide have near or distant vision impairment. In at least 1 billion of these cases, vision impairment could have been prevented or has yet to be addressed. Glaucoma, corneal disease, and retinal disorders are among the leading contributors to these vision impairments.

Since the pathogenesis of these eye diseases is not fully understood, fully effective treatments have yet to be developed. Considering this, Li et al. reviewed recent research to examine the effectiveness of exosomes in various diseases in vivo, which provides the potential for a new option for the treatment of eye diseases.

Exosomes are extracellular small vesicles that are formed by the regulation of endocytosis, fusion, and efflux and contain a variety of biologically active substances, including proteins, miRNAs, IncRNAs, and lipids.

Exosomes are found in all biological fluids and have roles that vary depending on their origin. These roles include cell-to-cell communication, waste transfer, and regulation of the immune system in vivo. Additionally, when serving as a carrier, exosomes are involved in many pathological processes such as nerve repair, vascular regeneration, immune response, and fibrosis formation.

Examining the various roles exosomes play within the body, the authors of this review consider their role in the treatment of serious ocular diseases, including glaucoma, diabetic retinopathy, and keratitis. Li et al. point to studies demonstrating exosomes’ ability to promote the repair of injured nerves, inhibit fibrosis, modulate immune function, and promote angiogenesis as evidence of the important role they have in treating ocular disease.

Specifically, exosomes contain a large number of immunosuppressive molecules that inhibit lymphocyte proliferation and effectively increase ocular immune tolerance to prevent ocular autoimmune disease.

Exosomes can also transfer protein and RNA to receptor cells and can accelerate wound healing of corneal epithelial cells, providing a new approach for treating large corneal lesions.

Studies have also demonstrated a link between exosomes and age-related macular degeneration (AMD) with specific exosomes considered to have neuroprotective effects that are closely related to the pathological progression of AMD.  

The authors conclude that exosomes are able to be used as therapeutic carriers to participate in processes such as immune response, angiogenesis, and nerve repair in ocular-related diseases. While research into this is still emerging, the presence and accessibility of exosomes will become a potential way to diagnose and treat ocular diseases.

Source: “Progress in exosomes and their potential use in ocular diseases.” 18 Sep. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459212/

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