Extracellular vesicles as novel biomarkers in allergy and autoimmunity - Clinical perspectives - To the Editor

Sep 30, 2026

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Letter emphasizing circulating extracellular vesicles (EVs) as promising biomarkers for immune activation in allergy and autoimmunity. EVs released by activated T cells, B cells, and dendritic cells carry cytokines, chemokines, and microRNAs, shaping local and systemic responses. The letter argues EV analysis could provide a real-time, noninvasive view of immune status in asthma and atopic dermatitis where conventional markers may not predict severity or therapy response. It also notes barriers including need for standardized EV isolation and characterization and robust longitudinal validation.

LanguageEnglish

CategoryHealthcare

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Reading Time3 min

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Correspondence and replies

To the Editor

Disclosure statement

References

Correspondence and replies Extracellular vesicles as novel biomarkers in allergy and autoimmunity: Clinical perspectives To the Editor: We read with great interest the article by Hara et al titled ‘‘Potential asthma biomarkers identified by nontargeted proteomics of extracellular vesicles in exhaled breath condensate’’ that was recently published in the Journal of Allergy and Clinical Immunology: Global and addressed dysregulation in chronic allergic disorders.1 In this context, we wish to emphasize the emerging role of circulating extracellular vesicles (EVs) as promising biomarkers of immune activation in allergy and autoimmunity. EVs shed by activated T cells, B cells, and dendritic cells encapsulate cytokines, chemokines, and microRNAs, thereby shaping local and systemic immune responses.2,3 This is particularly important in diseases such as asthma and atopic dermatitis, in which conventional markers such asIgE levels, eosinophil counts, and cytokine assay results often fail to predict clinical severity or response to targeted therapies.4 Incorporating EVanalysis may offer a real-time, noninvasive window into immune status, thereby enabling tailored use of biologics such as dupilumab and omalizumab.5 In line with this perspective, the article by Hara et al1 reporting that nontargeted proteomic profiling of EVs from exhaled breath condensate identified potential asthma biomarkers highlights the feasibility of EV-based approaches in capturing airway-specific molecular signatures, thus reinforcing our view that EVs can provide meaningful, disease-relevant insights beyond those provided by traditional biomarkers. Despite these advantages, significant barriers persist. Reliable, standardized methods for EV isolation and characterization are urgently needed, and robust longitudinal studies are required to confirm predictive value across different populations. Building on the findings of Hara et al, 1 we propose that integrating EV-cytokine interplay with proteomic signatures could refine disease monitoring and accelerate translation into clinical practice. In summary, EV-based biomarkers could mark a paradigm shift in precision monitoring and immunotherapy for allergic and autoimmune conditions. DISCLOSURE STATEMENT Disclosure of potential conflict of interest: The authors declare that they have no relevant conflicts of interest. M. Vijayasimha, PhD Rajesh Prasad Jayaswal, MSc From the Department of Medical Laboratory Technology, Chandigarh University, Mohali, [India. E-mail:](India. E-mail: mvsimha@gmail.com)[ mvsimha@gmail.com](India. E-mail: mvsimha@gmail.com). REFERENCES 1. Hara R, Takeda Y, Enomoto T, Yoshimura H, Yamamoto M, Tanizaki S, et al. Potential asthma biomarkers identified by nontargeted proteomics of extracellular vesicles in exhaled breath condensate. J Allergy Clin Immunol Glob 2025;4:100432 . 2. Thry C, Witwer KW, Aikawa E, et al. Minimal information for studies of extracellular vesicles 2023 (MISEV2023): progress and future directions. J Extracell Vesicles 2023;12:e12345 . 3. Gao F, Chiu M, Motazedian A, et al. Extracellular vesicles in allergic inflammation: emerging roles and clinical implications. Front Immunol 2022;13:875234 . 4. Agache I, Akdis CA. Precision medicine and phenotypes, endotypes, and biomarkers in allergic diseases. J Allergy Clin Immunol 2021;148:1449-63 . 5. Zissler UM, Esser-von Bieren J, Jakwerth CA, et al. Personalized medicine in allergy: extracellular vesicles as biomarkers for therapy monitoring. Allergy 2021; 76:3663-76 . [https://doi.org/10.1111/all.14896](https://doi.org/10.1111/all.14896) . [https://doi.org/10.1016/j.jacig.2025.100614](https://doi.org/10.1016/j.jacig.2025.100614) © 2025 The Author(s) . Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY-NCND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/lic

FAQs

What role do extracellular vesicles play in allergy and autoimmunity according to the letter?

They are presented as promising circulating biomarkers reflecting immune activation in allergy and autoimmunity. EVs from activated immune cells encapsulate signaling molecules that influence immune responses.

Why might EV analysis be valuable in asthma and atopic dermatitis?

The letter states conventional markers such as IgE levels, eosinophil counts, and cytokine assays may fail to predict clinical severity or response to targeted therapies. EV analysis is proposed as a real-time, noninvasive window into immune status.

What limitations and next steps are highlighted?

The letter emphasizes the urgent need for reliable, standardized methods for EV isolation and characterization. It also calls for robust longitudinal studies across different populations and suggests integrating EV–cytokine interplay with proteomic signatures for improved monitoring and translation.

Sep 30, 2026

Uploaded by Ophelia