Definition and Overview

Metabolic syndrome (MetS) is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. Recent research has highlighted the significant role of exosomes in the development and progression of MetS[1].

Exosomes as Regulators and Biomarkers

Exosomes have emerged as important regulators, biomarkers, and potential therapeutic targets in MetS. They act as messengers, mediating signaling transductions between metabolic cells and playing a bidirectional regulatory role in the MetS process[1].

Adipose Tissue-Derived Exosomes

• Exosomes from obese mice can induce glucose intolerance and insulin resistance in lean mice[2].
• Adipose tissue macrophage (ATM)-derived exosomes from obese mice can reduce the expression of key metabolic regulators like PPARγ and GLUT4, decreasing insulin sensitivity[2].
• miRNA-155 in ATM exosomes has been identified as a critical factor affecting metabolic disorders by inhibiting PPARγ[2].

Exosomes in Diabetes Treatment

Mesenchymal stem cell-derived exosomes (MSCs-Exos) have shown promising results in diabetes treatment:

• MSCs-Exos demonstrate comparable efficacy to MSCs in treating diabetes and its associated complications[3].
• In some studies, MSCs-Exos have shown superior therapeutic and regenerative effects compared to the original cells[3].
• Exosomes are considered a safer option than MSCs due to their lower amount of membrane-bound proteins and absence of direct tumorigenicity[3].

Exosomes in Insulin Resistance and Inflammation

• Exosomes from adipose tissue can interfere with insulin signaling in liver and muscle cells[4].
• A correlation has been observed between the number of exosomes released by omental adipose tissue and the HOMA insulin resistance index[4].
• Under obesity conditions, adipose tissue-derived exosomes promote the inflammatory state associated with the development of insulin resistance[4].