Eur J Pediatr Surg 2021; 31(04): 326-334
DOI: 10.1055/s-0041-1731294
Review Article

The Role of Exosomes in the Treatment, Prevention, Diagnosis, and Pathogenesis of COVID-19

Elke Zani-Ruttenstock
1   Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
,
Lina Antounians
1   Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
2   Developmental and Stem Cell Biology Program, Hospital for Sick Children, Toronto, Ontario, Canada
,
Kasra Khalaj
1   Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
2   Developmental and Stem Cell Biology Program, Hospital for Sick Children, Toronto, Ontario, Canada
,
Rebeca L. Figueira
1   Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
2   Developmental and Stem Cell Biology Program, Hospital for Sick Children, Toronto, Ontario, Canada
,
Augusto Zani
1   Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
2   Developmental and Stem Cell Biology Program, Hospital for Sick Children, Toronto, Ontario, Canada
3   Department of Surgery, University of Toronto, Toronto, Ontario, Canada
› Author Affiliations
Funding This work was supported by The Hospital for Sick Children (SickKids start-up funds).

Abstract

The novel coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), continues to be a major health concern. In search for novel treatment strategies against COVID-19, exosomes have attracted the attention of scientists and pharmaceutical companies worldwide. Exosomes are small extracellular vesicles, secreted by all types of cells, and considered as key mediators of intercellular communication and stem-cell paracrine signaling. Herein, we reviewed the most recent literature about the role of exosomes as potential agents for treatment, prevention, diagnosis, and pathogenesis of COVID-19. Several studies and ongoing clinical trials have been investigating the anti-inflammatory, immunomodulatory, and reparative effects of exosomes derived from mesenchymal stem/stromal cells for COVID-19-related acute lung injury. Other studies reported that exosomes play a key role in convalescent plasma therapy for COVID-19, and that they could be of use for the treatment of COVID-19 Kawasaki's-like multisystem inflammatory syndrome and as drug delivery nanocarriers for antiviral therapy. Harnessing some advantageous aspects of exosome biology, such as their endogenous origin, capability of crossing biological barriers, high stability in circulation, and low toxicity and immunogenicity, several companies have been testing exosome-based vaccines against SARS-CoV-2. As they carry cargos that mimic the status of parent cells, exosomes can be isolated from a variety of sources, including plasma, and employed as biomarkers of COVID-19. Lastly, there is growing evidence supporting the role of exosomes in COVID-19 infection, spread, reactivation, and reinfection. The lessons learned using exosomes for COVID-19 will help determine their efficacy and applicability in other clinical conditions.

Note

[Figs. 2] and [3] were created with BioRender.com




Publication History

Received: 24 April 2021

Accepted: 10 May 2021

Publication Date:
23 June 2021 (online)

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