Exosomal Biomarkers: A Comprehensive Overview of Diagnostic and Prognostic Applications in Malignant and Non-Malignant Disorders

Sep 23, 2026

Uploaded by James

Exosomes are small extracellular vesicles (30–150 nm) that mediate intercellular communication and can function as biomarkers because they reflect cellular genetic and proteomic states. Their biomarker role supports real-time, noninvasive liquid biopsy approaches, offering potential for earlier cancer detection and individualized treatment planning. Analysis indicates increasing use of exosomes since 2012, with a higher share of malignant indications. Applications span gastrointestinal, thoracic, urogenital cancers and disorders including cardiovascular, diabetic, breathing, infectious, and brain conditions, supported by review of registered clinical trials.

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1. Introduction

Review Exosomal Biomarkers: A Comprehensive Overview of Diagnostic and Prognostic Applications in Malignant and Non-Malignant Disorders Mahda Delshad 1,2, Mohammad-Javad Sanaei 1, Mohammad Hossein Mohammadi 1, Amir Sadeghi 3 and Davood Bashash 1, * Academic Editor: IlJe Yu Received: 19 February 2025 Revised: 7 April 2025 Accepted: 9 April 2025 Published: 15 April 2025 Citation: Delshad, M.; Sanaei, M.-J.; Mohammadi, M.H.; Sadeghi, A.; Bashash, D. Exosomal Biomarkers: A Comprehensive Overview of Diagnostic and Prognostic Applications in Malignant and Non-Malignant Disorders. Biomolecules 2025, 15, 587. [https://](https://)[ ](https://)[doi.org/10.3390/biom15040587](doi.org/10.3390/biom15040587) [Copyright:](Copyright:) © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran; [delshad.mahda@gmail.com](delshad.mahda@gmail.com) (M.D.); [javadsanaei137@gmail.com](javadsanaei137@gmail.com) (M.-J.S.); [drmohammadi@sbmu.ac.ir](drmohammadi@sbmu.ac.ir) (M.H.M.) 2 Department of Laboratory Sciences, School of Allied Medical Sciences, Zanjan University of Medical Sciences, Zanjan 1411718541, Iran 3 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran; [amirsadeghimd@yahoo.com](amirsadeghimd@yahoo.com) * Correspondence: [david_5980@yahoo.com](david_5980@yahoo.com); Tel.: +98-21-22717504 Abstract: Exosomes are small extracellular vesicles, ranging from 30 to 150 nm, that are essential in cell biology, mediating intercellular communication and serving as biomarkers due to their origin from cells. Exosomes as biomarkers for diagnosing various illnesses have gained significant investigation due to the high cost and invasive nature of current diagnostic procedures. Exosomes have a clear advantage in the diagnosis of diseases because they include certain signals that are indicative of the genetic and proteomic profile of the ailment. This feature gives them the potential to be useful liquid biopsies for real-time, noninvasive monitoring, enabling early cancer identification for the creation of individualized treatment plans. According to our analysis, the trend toward utilizing exosomes as diagnostic and prognostic tools has raised since 2012 . In this regard, the proportion of malignant indications is higher compared with non-malignant ones. To be precise, exosomes have been used the most in gastrointestinal, thoracic, and urogenital cancers, along with cardiovascular, diabetic, breathing, infectious, and brain disorders. To the best of our knowledge, this is the first research to examine all registered clinical trials that look at exosomes as a diagnostic and prognostic biomarker. Keywords: exosome; diagnosis; prognosis; clinical trial; malignancy disorders; non-malignancy disorders 1. Introduction Both prokaryotic and eukaryotic cells produce exosomes, which are small (30–150 nm), phospholipid bilayer extracellular vesicles used for signaling and intercellular communication [1] . Exosome is a biogenesis-related term exhibiting origin from the endosomal system. Being typically smaller than 200 nm, exosomes are a subtype of small extracellular vesicles (EVs) [2] . Indeed, they were formerly thought to be extracellular vesicles that expel undesirable cellular trash. Nevertheless, several studies have shown that exosomes are crucial molecular mediators for interaction between cells in the movement of different nucleic acids, proteins, and metabolites within the body [3,

FAQs

What are exosomes and why are they considered useful biomarkers?

Exosomes are small extracellular vesicles (30–150 nm) that mediate intercellular communication. Because they originate from cells and carry signals tied to genetic and proteomic profiles, they can indicate disease states.

How do exosomes support diagnostic and prognostic applications?

Exosomes contain relevant molecular content such as proteins, miRNA, and lncRNA, and their markers and tumor-related signals can aid diagnosis. Their profiles can also help monitor disease course and prognosis through noninvasive approaches.

What evidence is described regarding trends and disease coverage?

The text reports that interest in using exosomes as diagnostic and prognostic tools has risen since 2012. It also notes that exosome-based work is common in gastrointestinal, thoracic, and urogenital cancers and extends to cardiovascular, diabetic, breathing, infectious, and brain disorders.

Sep 23, 2026

Uploaded by James