Extracellular vesicles in pulmonary diseases: roles and therapeutic potential

Extracellular vesicles (EVs) are small lipid bilayer packages responsible for cellular communication. Increasing clinical and experimental evidence strongly links EVs to homeostasis and the pathogenesis of disease. In this review, we provide a brief overview of EVs and their biological significance in pulmonary disease. We outline the current challenges in diagnosis and treatment of lung diseases and discuss the rationale for exploring EVs as a novel therapeutic avenue. Beyond their biomarker potential, we outline the role and potential for therapeutic targeting of EVs in the pathogenesis of asthma, chronic obstructive pulmonary disease (COPD), lung cancer, and infectious diseases. We also explore the current literature on the use of stem cell derived EVs to drive lung repair and regeneration in inflammatory diseases. Lastly, we highlight challenges and limitations of the study of EVs in pulmonary disease and provide future perspectives with exciting opportunities for translation into therapy.