Roles of Extracellular Vesicles in Multiple Sclerosis: From Pathogenesis to Potential Tools as Biomarkers and Therapeutics

Abstract

Extracellular vesicles (EVs) are involved in the regulation of immune system functioning and central nervous system (CNS) homeostasis, suggesting a possible role in multiple sclerosis (MS). Indeed, by carrying several types of mediators, such as cytokines, enzymes, and RNAs, EVs can display both anti- and pro-inflammatory roles on the innate and adaptive immune system, and are involved in several CNS functions, including neuronal plasticity, trophic support, disposal of cellular components, axonal maintenance and neuroprotection. In this review, we provide an overview of the studies carried out to understand the role of EVs in the compromised immune system and CNS functioning typical of MS. Moreover, we also highlight the potential of EVs for the diagnosis of this disorder, thanks to their ability to cross the blood-brain barrier (BBB). In addition, we describe the advances in the use of EVs as therapeutic agents by describing their therapeutic potential.