Extracellular Vesicles in Idiopathic Pulmonary Fibrosis: Pathogenesis, Biomarkers and Innovative Therapeutic Strategies

Int J Nanomedicine. 2024 Nov 25:19:12593-12614. doi: 10.2147/IJN.S491335. eCollection 2024.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and irreversible interstitial lung disease caused by aberrant deposition of extracellular matrix in the lungs with significant morbidity and mortality. The therapeutic choices for IPF remain limited. Extracellular vesicles (EVs), as messengers for intercellular communication, are cell-secreted lipid bilayer nanoscale particles found in body fluids, and regulate the epithelial phenotype and profibrotic signaling pathways by transporting bioactive cargo to recipients in the pathogenesis of IPF. Furthermore, an increasing number of studies suggests that EVs derived from stem cells can be employed as a cell-free therapeutic approach for IPF, given their intrinsic tissue-homing capabilities and regeneration characteristics. This review highlights new sights of EVs in the pathogenesis of IPF, their potential as diagnostic and prognostic biomarkers, and prospects as novel drug delivery systems and next-generation therapeutics against IPF. Notably, bringing engineering strategies to EVs holds great promise for enhancing the therapeutic effect of anti-pulmonary fibrosis and promoting clinical transformation.

Keywords: diagnosis; extracellular vesicles; idiopathic pulmonary fibrosis; pathogenesis; therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Biomarkers* / metabolism
  • Drug Delivery Systems / methods
  • Extracellular Vesicles* / metabolism
  • Humans
  • Idiopathic Pulmonary Fibrosis* / metabolism
  • Idiopathic Pulmonary Fibrosis* / therapy
  • Lung / metabolism
  • Lung / pathology

Substances

  • Biomarkers

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 82304862), the Zhejiang Provincial Natural Science Foundation of China (LQ23H300007), the Zhejiang Province Medical and Health Science and Technology Plan Project (2023RC150), the Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project (2023ZR103), and the Zhejiang Pharmaceutical Association Hospital Pharmacy Special Scientific Research Funding Project (2022ZYY01).