Role of Extracellular Vesicles in Viral and Bacterial Infections: Pathogenesis, Diagnostics, and Therapeutics
Open accessAbstract
Extracellular vesicles (EVs), or exosomes, are nanovesicles of endocytic origin that carry host and pathogen-derived protein, nucleic acid, and lipid cargos. They are secreted by most cell types and play important roles in normal cell-to-cell communications but can also spread pathogen- and host-derived molecules during infections to alter immune responses and pathophysiological processes. New research is beginning to decipher how EVs influence viral and bacterial pathogenesis. In this review, we will describe how EVs influence viral and bacterial pathogenesis by spreading pathogen-derived factors and how they can promote and inhibit the immune response to these pathogens. We will also discuss the emerging potential of EVs as diagnostic and therapeutic tools.
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Many viruses such as HIV, coxsackievirus, hepatitis B and C, influenza, Epstein-Barr virus, and SARS-CoV-2 hijack cellular and mitochondrial programs to enhance viral replication, package virus into EVs, and use EVs containing virus or viral components to subvert the immune response to obtain a replicative advantage in the host.
“Many viruses such as HIV, coxsackievirus, hepatitis B and C, influenza, Epstein-Barr virus, and SARS-CoV-2 highjack cellular and mitochondrial programs to enhance viral replication, package virus into EVs, and use EVs containing virus or viral components to subvert the immune response to obtain a replicative advantage in the host (Figure 1).”
From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [47]
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Experimental — accuracy not yet measuredCardiomyocytes and pericytes express ACE2 and TMPRSS2, as well as other accessory proteins needed for viral infection by SARS-CoV-2.
“Thus, cardiomyocytes and pericytes express ACE2 and TMPRSS2, as well as other accessory proteins (ie, NRP1 [neuropilin-1 receptor], CD147 , integrin α 5 β 1, and cathepsin B/L) needed for viral infection by SARS-CoV-2”
From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [27]
The Viruses section discusses extracellular vesicles transferring receptors involved in HIV infection and affecting hepatitis-virus infection. Searches of our copy for cardiomyocytes, pericytes, ACE2, TMPRSS2, SARS-CoV-2, and the named accessory proteins found no passage addressing their expression or role in SARS-CoV-2 infection. (LLM, conf=0.78)
Experimental — accuracy not yet measuredAn engineered heart tissue model of COVID-19 found that SARS-CoV-2 infection of heart tissue led to contractile issues, sarcomere disassembly, TNFα cytokine production, macrophage infiltration, and cell death, mimicking viral myocarditis.
“An engineered heart tissue model of COVID-19 found that SARS-CoV-2 infection of the heart tissue led to contractile issues, sarcomere disassembly, TNF α cytokine production, macrophage infiltration, and cell death, mimicking viral myocarditis. 27”
From COVID-19, Myocarditis and Pericarditis (2023) · cites this paper as [27]
The Viruses section discusses extracellular vesicles in infections such as HIV and hepatitis, while the Bacteria section describes TNFα production and macrophage recruitment in mycobacterial infections. Searches for SARS-CoV-2, engineered heart tissue, sarcomere disassembly, and viral myocarditis found no passage addressing the claimed model or its outcomes. No page numbers were provided for these sections. (LLM, conf=0.78)
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- Authors
- Rodrigues, M., Fan, J., Lyon, C., Wan, M., & Hu, Y.
- Affiliations
- Arizona State University (US)
- West China Medical Center of Sichuan University (CN)
- Corresponding author
- Wan, Meihua
- Hu, Ye
- Venue
- Theranostics
- Publisher
- Ivyspring International Publisher
- Published
- 2018
- Volume
- 8
- Issue
- 10
- Pages
- 2709-2721
- ISSN
- 1838-7640 (ISSN-L)
- PMC
- PMC5957004
- OpenAlex
- W2802105343
- Cited by
- 191
- References
- 112
- Citations by year
- 2026: 17 · 2025: 19 · 2024: 17 · 2023: 20 · 2022: 25 · 2021: 38 · 2020: 36 · 2019: 17 · 2018: 2
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Theranostics (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (R01AI113725, R21AI126361, R01AI122932)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD090927)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Extracellular vesicles in disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Cellular transport and secretion
- Physical Sciences › Materials Science › Biomaterials › Nanoparticle-Based Drug Delivery
- Keywords
- extracellular vesicles, exosomes, viral infection, bacterial infection, pathogenesis, immunomodulation, pathogen dispersal, cell-to-cell communication, diagnostics, therapeutics
- MeSH terms
- Extracellular Vesicles, Theranostic Nanomedicine, Animals, Bacterial Infections, Humans, Virus Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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