Exosomes as a delivery tool of exercise-induced beneficial factors for the prevention and treatment of cardiovascular disease: a systematic review and meta-analysis

Figures

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  FIGURE 1. Flowchart of the study selection process in the systematic review according to PRISMA guidelines.

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  FIGURE 2. Risk of bias results. Review authors’ judgments about each risk of bias item for each included study. +, low risk of bias; -, high risk of bias; ?, unclear risk of bias.

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  FIGURE 3. Contour-enhanced funnel plot of outcome indicators. Yellow dot, A total of seven articles provided relevant data on the myocardial apoptosis (n = 7); red dot, A total of four articles provided relevant data on the myocardial infarction volume (n = 4); green dot, A total of four articles provided relevant data on the angiogenesis (n = 4); purple dot, A total of two articles provided relevant data on the microvessel density (n = 2); blue dot, A total of two articles provided relevant data on the left ventricular ejection fraction (n = 2). , 1% < p < 5%; , 5% < p < 10%; , p > 10%; , Estimated θⅣ.

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  FIGURE 4. Forest plot of outcome indicators (A), Myocardial apoptosis; (B), Myocardial infarction volume; (C), Angiogenesis; (D), Microvessel density; (E), Left ventricular ejection fraction.

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  FIGURE 5. Exercise-induced release of exosome source, isolation method, characterization, exosome markers (proteins) and exosome-carried cargos.

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  FIGURE 6. Exercise induces multiple tissues to release exosomes, which mediate cardiovascular protection. The main effects of exercise on exosome source of release, which can derive from different organs (liver, brain, muscle, heart, and adipose tissue), cargo, and exercise-released exosome-carried miRNAs predicted actions. Exercise promotes cardiovascular health by mediating cell-to-cell communication and cross-talk between organs and tissues—exosomes are significant vehicles for miRNAs and proteins.