Exosomal Shuttle RNAs (esRNAs) as Diagnostic, Prognostic and Therapeutic Tools: New Frontiers in Precision Medicine

The exosomes have recently emerged as key players in modulating different physiological and pathological processes including tumor progression, neurodegenerative disorders, cardiovascular diseases, osteoarthritis, angiogenesis, wound healing and immune responses. They are vital for cell- to- cell communication and in maintaining cellular homeostasis via cell proliferation, differentiation and apoptosis. Exosomes carry a diverse cargo of bioactive molecules such as signaling proteins, membrane proteins, DNA, RNAs, metabolites and pathological molecules, that can be transferred to the recipient cells. Among these, the exosomal shuttle RNAs (esRNAs), which primarily include coding and non-coding RNAs (ncRNAs) such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs) and small interference RNAs (siRNAs), have gained significant attention for their involvement not only in diseases pathogenesis but also in diagnosis as well as RNA based precision therapeutics across a spectrum of diseases and is the focus of this review article.