2024, Vol. 28 ›› Issue (2): 315-320

Extracellular vesicles in sarcopenic obesity: roles and mechanisms

Long Yi1, 2, Yang Jiaming1, 2, Ye Hua1, 2, Zhong Yanbiao3, 4, Wang Maoyuan2, 5   

Abstract: BACKGROUND: Extracellular vesicles can regulate insulin resistance and control inflammatory response by participating in intercellular communication, while repairing skeletal muscles and promoting skeletal muscle regeneration, which is expected to be a novel treatment modality for sarcopenic obesity.
OBJECTIVE: To review the biogenesis of extracellular vesicles, their biological functions, their relationship with sarcopenic obesity, and recent advances in the pathogenesis, diagnosis, and treatment of sarcopenic obesity.
METHODS: The first author performed a computer search of PubMed, Embase, CNKI and other databases for relevant studies involving extracellular vesicle in sarcopenic obesity. The search keywords were “extracellular vesicle, exosome, sarcopenic obesity, obese sarcopenia, skeletal muscle regeneration, skeletal muscle mass regulation” in English and Chinese, respectively. The search period was from June 2022 to November 2022. After screening, 87 articles were included for further review.
RESULTS AND CONCLUSION: Extracellular vesicles are important vectors of bidirectional cell communication and participate in the regulation of normal physiological and pathological processes through autocrine, paracrine and endocrine ways. Sarcopenic obesity is a complex multi-factor disease. Extracellular vesicles are involved in the occurrence and development of sarcopenic obesity mainly by regulating the inflammatory response of skeletal muscle and the homeostasis of muscle cells. Cytokines secreted by adipose tissue and skeletal muscle are released into the extracellular circulation through extracellular vesicle encapsulation and interact with each other to promote skeletal muscle insulin resistance and lipogenesis, which is the main pathophysiology of skeletal muscle atrophy in sarcopenic obesity. Extracellular vesicles not only promote the development of sarcopenic obesity by providing specific pathogenic markers, but also are a valuable diagnostic indicator of sarcopenic obesity. Release of extracellular vesicles from skeletal muscle during exercise enhances metabolic response and promotes skeletal muscle regeneration. Extracellular vesicles can not only be used as therapeutic targets for sarcopenic obesity but also be used to treat sarcopenic obesity by loading drugs to effectively improve drug bioavailability.

Key words: extracellular vesicle, exosome, sarcopenic obesity, obese sarcopenia, aging lipid metabolism abnormality, skeletal muscle regeneration, metabolic homeostasis, inflammation, intercellular communication, review