Potential role of exosomes in the pathophysiology, diagnosis, and treatment of hypoxic diseases.

Exosomes are extracellular vesicles that originate in the endosomal system. They perform important functions for cell-to-cell communication by transferring bioactive cargoes to recipient cells or activating signal transduction pathways in the target cells. Hypoxia is a severe cellular stress that can regulate the release of exosomes and change their contents. Exosomes have been investigated in different types of hypoxic diseases and found to have many effects from pathology to protection. Increasingly, studies have indicated that exosomes can reflect their cellular origin and disease state through the bioactive cargoes they carry, making exosomes useful as potential biomarkers for diagnosing or predicting hypoxic diseases. In this review, we summarize the effects and mechanisms of hypoxia on exosomes and introduce the basics of exosome production, release, and uptake. In addition, we also summarize current information on the involvement, diagnostic value, and therapeutic potential of exosomes in different types of hypoxic diseases, including myocardial infarction (MI), renal ischemia-reperfusion (IR) induced acute kidney injury (AKI) and hypoxic tumors.