治疗耐药性的发展仍然是治疗癌症的主要障碍,导致治疗成功率受损和患者发病率增加。建立微创液体活检是提高早期诊断的一种有前途的方法,以及治疗监测,实体瘤。由于它们在肿瘤微环境中的多种功能,肿瘤相关的小细胞外囊泡,被称为外泌体,已经成为一个激烈研究的课题。除了它们在癌症进展中的重要作用,转移,和免疫反应,有人提出,外泌体也有助于治疗抗性的获得和转移,主要通过提供功能性蛋白质和RNA,以及促进活性药物的出口或充当细胞外诱饵。广泛的研究集中在理解抗性发生的分子机制并将其转化为早期检测的策略。通过这次审查,我们想提供有关外来体(病理)生物学的当前知识的概述,以及最先进的分离和分析方法。此外,我们强调了外泌体在肿瘤发生和癌症治疗中的作用,它们可以作为治疗剂,生物标志物,和/或目标。通过关注它们在治疗抵抗中的作用,我们将揭示利用外泌体进行癌症诊断和治疗的新途径。
The development of therapy resistance still represents a major hurdle in treating cancers, leading to impaired treatment success and increased patient morbidity. The establishment of minimally invasive liquid biopsies is a promising approach to improving the early diagnosis, as well as therapy monitoring, of solid tumors. Because of their manifold functions in the tumor microenvironment, tumor-associated small extracellular vesicles, referred to as exosomes, have become a subject of intense research. Besides their important roles in cancer progression, metastasis, and the immune response, it has been proposed that exosomes also contribute to the acquisition and transfer of therapy resistance, mainly by delivering functional proteins and RNAs, as well as facilitating the export of active drugs or functioning as extracellular decoys. Extensive research has focused on understanding the molecular mechanisms underlying the occurrence of resistance and translating these into strategies for early detection. With this review, we want to provide an overview of the current knowledge about the (patho-)biology of exosomes, as well as state-of-the-art methods of isolation and analysis. Furthermore, we highlight the role of exosomes in tumorigenesis and cancer treatment, where they can function as therapeutic agents, biomarkers, and/or targets. By focusing on their roles in therapy resistance, we will reveal new paths of exploiting exosomes for cancer diagnosis and treatment.