The role and therapeutic potential of extracellular vesicles in atherosclerosis
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Atherosclerosis, the pathophysiology of many cardiovascular diseases (CVD), is a chronic inflammatory process caused by the sustained accumulation of cholesterol, followed by endothelial dysfunction, and the resulting vascular inflammation. The established treatment for atherosclerosis, to date, involves the use of statins. These medications are hydroxymethylglutaryl coenzyme A reductase (HMG-CoA) inhibitors and lower the levels of by inhibiting HMG-CoA, a rate limiting step in the biosynthesis of cholesterol. Statin therapy varies in effectiveness based on dosage and individual differences, making effective treatment of patients challenging. More recently, extracellular vesicles (EVs) have emerged as a promising field in cardiovascular research. Once thought of as “platelet dust,” EVs are now recognized for their potential as therapeutic targets and tools. In this review, a comprehensive characterization of EVs is provided to explain how EVs are involved in normal physiological function and pathological processes of atherosclerosis. Evidence supports a model where EVs participate in the initiation and progression of atherosclerosis and may also be used as a delivery tool in disease therapy. Currently, cell-derived EVs can be therapeutic agents in animal models, an effective tool in gene therapy, or a drug delivery vehicle. Future experiments enhancing the therapeutic potential of EVs promise to deepen our understanding of EV-based therapy for atherosclerosis precision medicine.