J Clin Immunol. 2025 Nov 28. doi: 10.1007/s10875-025-01965-0. Online ahead of print.

ABSTRACT

Exosomes, as integral mediators of cellular communication, have emerged as crucial players in the pathogenesis and potential treatment of autoimmune diseases. This review explores the dual role of exosomes in mediating autoantigen presentation and their impact on immune dysregulation. Exosomes, by virtue of their cargo-comprising proteins, peptides, and nucleic acids-can influence immune tolerance, potentially leading to the breakdown of self-tolerance and the perpetuation of autoimmune responses. They carry and present autoantigens directly to T cells or indirectly via antigen-presenting cells, thereby initiating and sustaining immune reactions characteristic of autoimmune disorders. Furthermore, the review delves into the therapeutic implications of targeting exosomal pathways, discussing strategies such as inhibiting exosome biogenesis, modifying exosomal content, and blocking exosome uptake by immune cells. Such interventions present promising avenues for developing novel treatments aimed at mitigating autoimmune responses. By harnessing the unique properties of exosomes, future research may pave the way for innovative therapeutic strategies that offer more precise and personalized treatment options for patients suffering from autoimmune diseases.

PMID:41315078 | DOI:10.1007/s10875-025-01965-0