Extracellular Vesicles and Diabetic Retinopathy: Nano-sized Vesicles With Mega-sized Hopes

Abstract

Diabetic retinopathy (DR) is a major health problem, being the leading cause of vision loss in the working-age group. Novel discoveries facilitating the early diagnosis and curative treatment of DR are still greatly needed. Extracellular vesicles (EVs) are nano-sized vesicles released from different kinds of body cells including various retinal cells for intercellular communication. EVs recently attracted attention because of their non-immunogenic, biocompatible, and biodegradable characteristics. Recent studies investigated EV cargoes in DR patient samples, animal models, and in vitro models of DR. Although a thorough understanding of the trafficking of EVs in the retina still needs extensive investigations, these studies will pave the way for the discovery of novel biomarkers for early diagnosis of DR. Furthermore, EVs-based therapeutics could be of great interest in the treatment of DR. They are presented as promising delivery tools for both pharmacological and genetic therapies. Here, we highlighted the studies that discussed the role of EVs in both inflammation and angiogenesis as two main pathophysiological events occurring in DR. We also tried to portray what we know so far about the role of EVs in DR as a diagnostic, prognostic, and therapeutic tool.