Álvaro González, Silvia López-Borrego, Amaia Sandúa, Mar Vales-Gomez, Estibaliz Alegre
{"title":"Extracellular vesicles in cancer: challenges and opportunities for clinical laboratories.","authors":"Álvaro González, Silvia López-Borrego, Amaia Sandúa, Mar Vales-Gomez, Estibaliz Alegre","doi":"10.1080/10408363.2024.2309935","DOIUrl":null,"url":null,"abstract":"<p><p>Extracellular vesicles (EVs) are nano-sized particles secreted by most cells. They transport different types of biomolecules (nucleic acids, proteins, and lipids) characteristic of their tissue or cellular origin that can mediate long-distance intercellular communication. In the case of cancer, EVs participate in tumor progression by modifying the tumor microenvironment, favoring immune tolerance and metastasis development. Consequently, EVs have great potential in liquid biopsy for cancer diagnosis, prognosis and follow-up. In addition, EVs could have a role in cancer treatment as a targeted drug delivery system. The intense research in the EV field has resulted in hundreds of patents and the creation of biomedical companies. However, methodological issues and heterogeneity in EV composition have hampered the advancement of EV validation trials and the development of EV-based diagnostic and therapeutic products. Consequently, only a few EV biomarkers have moved from research to clinical laboratories, such as the ExoDx Prostate IntelliScore (EPI) test, a CLIA/FDA-approved EV prostate cancer diagnostic test. In addition, the number of large-scale multicenter studies that would clearly define biomarker performance is limited. In this review, we will critically describe the different types of EVs, the methods for their enrichment and characterization, and their biological role in cancer. Then, we will specially focus on the parameters to be considered for the translation of EV biology to the clinic laboratory, the advances already made in the field of EVs related to cancer diagnosis and treatment, and the issues still pending to be solved before EVs could be used as a routine tool in oncology.</p>","PeriodicalId":10760,"journal":{"name":"Critical reviews in clinical laboratory sciences","volume":null,"pages":null},"PeriodicalIF":6.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical reviews in clinical laboratory sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10408363.2024.2309935","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Extracellular vesicles (EVs) are nano-sized particles secreted by most cells. They transport different types of biomolecules (nucleic acids, proteins, and lipids) characteristic of their tissue or cellular origin that can mediate long-distance intercellular communication. In the case of cancer, EVs participate in tumor progression by modifying the tumor microenvironment, favoring immune tolerance and metastasis development. Consequently, EVs have great potential in liquid biopsy for cancer diagnosis, prognosis and follow-up. In addition, EVs could have a role in cancer treatment as a targeted drug delivery system. The intense research in the EV field has resulted in hundreds of patents and the creation of biomedical companies. However, methodological issues and heterogeneity in EV composition have hampered the advancement of EV validation trials and the development of EV-based diagnostic and therapeutic products. Consequently, only a few EV biomarkers have moved from research to clinical laboratories, such as the ExoDx Prostate IntelliScore (EPI) test, a CLIA/FDA-approved EV prostate cancer diagnostic test. In addition, the number of large-scale multicenter studies that would clearly define biomarker performance is limited. In this review, we will critically describe the different types of EVs, the methods for their enrichment and characterization, and their biological role in cancer. Then, we will specially focus on the parameters to be considered for the translation of EV biology to the clinic laboratory, the advances already made in the field of EVs related to cancer diagnosis and treatment, and the issues still pending to be solved before EVs could be used as a routine tool in oncology.
细胞外囊泡(EVs)是大多数细胞分泌的纳米级颗粒。它们运输不同类型的生物大分子(核酸、蛋白质和脂质),这些大分子具有其组织或细胞来源的特征,可以介导长距离的细胞间通信。就癌症而言,EVs 可通过改变肿瘤微环境、促进免疫耐受和转移发展来参与肿瘤进展。因此,EVs 在用于癌症诊断、预后和随访的液体活检中具有巨大潜力。此外,EVs 还可作为靶向给药系统在癌症治疗中发挥作用。EV 领域的深入研究已产生了数百项专利,并创建了多家生物医学公司。然而,方法问题和 EV 成分的异质性阻碍了 EV 验证试验的进展以及基于 EV 的诊断和治疗产品的开发。因此,只有少数 EV 生物标志物从研究阶段进入了临床实验室,如 ExoDx Prostate IntelliScore(EPI)检测,这是一种获得 CLIA/FDA 批准的 EV 前列腺癌诊断检测。此外,能明确界定生物标记物性能的大规模多中心研究数量有限。在这篇综述中,我们将对不同类型的 EVs、其富集和表征方法及其在癌症中的生物学作用进行批判性描述。然后,我们将特别关注将 EV 生物学转化为临床实验室需要考虑的参数、与癌症诊断和治疗相关的 EV 领域已取得的进展,以及在将 EV 用作肿瘤学常规工具之前仍有待解决的问题。
期刊介绍:
Critical Reviews in Clinical Laboratory Sciences publishes comprehensive and high quality review articles in all areas of clinical laboratory science, including clinical biochemistry, hematology, microbiology, pathology, transfusion medicine, genetics, immunology and molecular diagnostics. The reviews critically evaluate the status of current issues in the selected areas, with a focus on clinical laboratory diagnostics and latest advances. The adjective “critical” implies a balanced synthesis of results and conclusions that are frequently contradictory and controversial.