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Nat Rev Cardiol. 2017 May;14(5):259-272. doi: 10.1038/nrcardio.2017.7. Epub 2017 Feb 2.

Extracellular vesicles in coronary artery disease.

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Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 970, Paris Cardiovascular Research Center - PARCC, 56 rue Leblanc, 75737 Paris cedex 15, France.
Université Paris Descartes, Sorbonne Paris Cité, UMR-S970, 56 rue Leblanc, 75737 Paris cedex 15, France.
Service d'Hépatologie, DHU Unity Hôpital Beaujon, APHP, 100 boulevard du général Leclerc, 92100 Clichy, France.
Université Denis Diderot-Paris 7, Sorbonne Paris Cité, 16 rue Henri Huchard, 75018 Paris, France.
Institut Mutualiste Monsouris, Cardiology Department, 42 Boulevard Jourdan, 75014 Paris, France.


Membrane vesicles released in the extracellular space are composed of a lipid bilayer enclosing soluble cytosolic material and nuclear components. Extracellular vesicles include apoptotic bodies, exosomes, and microvesicles (also known previously as microparticles). Originating from different subcellular compartments, the role of extracellular vesicles as regulators of transfer of biological information, acting locally and remotely, is now acknowledged. Circulating vesicles released from platelets, erythrocytes, leukocytes, and endothelial cells contain potential valuable biological information for biomarker discovery in primary and secondary prevention of coronary artery disease. Extracellular vesicles also accumulate in human atherosclerotic plaques, where they affect major biological pathways, including inflammation, proliferation, thrombosis, calcification, and vasoactive responses. Extracellular vesicles also recapitulate the beneficial effect of stem cells to treat cardiac consequences of acute myocardial infarction, and now emerge as an attractive alternative to cell therapy, opening new avenues to vectorize biological information to target tissues. Although interest in microvesicles in the cardiovascular field emerged about 2 decades ago, that for extracellular vesicles, in particular exosomes, started to unfold a decade ago, opening new research and therapeutic avenues. This Review summarizes current knowledge on the role of extracellular vesicles in coronary artery disease, and their emerging potential as biomarkers and therapeutic agents.

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