Published online Jun 14, 2020. doi: 10.3748/wjg.v26.i22.2889
Peer-review started: December 28, 2019
First decision: March 21, 2020
Revised: March 26, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: June 14, 2020
Exosomes, a class of extracellular vesicles, are small membrane-bound vesicles derived from almost all cell types that can play important roles in intercellular communication. Exosomes contain proteins, lipids, and nucleic acids that are obtained from the parental cells and participate in various pathophysiological processes, including cell growth, migration, inflammation, immune regulation, and tumor pathogenesis. Moreover, exosomes might be applied in clinical settings, such as diagnosis, treatment, and outcome prediction of diseases, including various cancers. The incidence rates of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) have increased in recent decades, and studies have proposed specific factors that may contribute to the development and progression of these diseases. However, how exosomes play a role in this pathological process needs to be clarified. Studies have identified candidate microRNAs (miRNAs) that might be related to BE/EAC. Further studies are needed to ascertain whether circulating exosomal miRNAs are altered before or after disease onset, which could also help understand the pathophysiology of and find potential targets for prevention, diagnosis, and therapy in BE/EAC. This review summarizes recent findings on the features of circulating exosomal miRNAs in BE/EAC, which could be valuable for the early diagnosis, therapeutic approaches, and outcome prediction of BE/EAC.
Core tip: Barrett's esophagus (BE) is the only recognized precursor of esophageal adenocarcinoma (EAC), which is a common malignancy with a poor prognosis. Exosomes contain proteins, lipids, and nucleic acids and participate in various pathophysiological processes. The role of exosomes in BE/EAC progression cannot be ignored. Current studies on circulating exosomal microRNAs (miRNAs) in BE/EAC have mainly focused on miRNA profiling, and little is known about the associations between circulating exosomes and the pathogenesis of BE/EAC. This review focuses on the features of circulating exosomal miRNAs in BE/EAC, which might be potential biomarkers and play a causative role in BE/EAC pathogenesis.