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Jayachandran et al. Hepatoma Res 2018;4:44 I http://dx.doi.org/10.20517/2394-5079.2018.59 Page 9 of 12

Tumour-derived exosomes have been described as regulators of metabolic reprogramming in various
tumour microenvironments . Metabolic reprogramming is a process whereby tumours increase their
[65]
glucose availability by suppressing uptake of glucose by non-tumour cells . However, their role in HCC
[66]
remains to be elucidated. Although a few studies have explored the role of exosomes in EMT and cancer stem
cells, further studies are warranted in these areas. Another relevant aspect is angiogenesis, a major process
which regulates nutrient availability of fast growing solid tumours . The role of exosomes in facilitating
[10]
angiogenesis and its consequence on HCC metastasis remain unexplored. Collectively, these phenomena
impose major challenges on cancer treatment and both in vitro and in vivo studies in these areas will lay the
foundation for future clinical trials.

CONCLUSION
Exosomes are biologically active nanovesicles that can transfer information to recipient cells to mediate local
as well as distant cell-cell communication. In summary, increasing number of studies has shown that HCC-
derived exosomes are potent mediators of tumor growth, proliferation and motility. They also play a pivotal
role in moulding the host immune response. Other relevant aspects influenced by HCC-derived exosomes
are chemoresistance, EMT and CSCs. The ease of isolating exosomes and their content from different body
fluids may provide a new source of biomarkers with application in diagnosis, prognosis and in monitoring
disease progression during and after treatment. Moreover, exosomes have shown great potential as drug
delivery systems for the treatment of HCC. Overall, exosomes show a tremendous potential for better cancer
care and effective treatment outcomes for HCC.

DECLARATIONS
Authors’ contributions
Conception and manuscript writing, provision of study materials, collection and assembly of data, and final
approval of manuscripts: Jayachandran A, Manda SV, Shrestha R, Bridle KR, Prithviraj P, Crawford DHG

Availability of data and materials
Not applicable.

Financial support and sponsorship
This manuscript publication is funded by Gallipoli Medical Research Foundation.

Conflicts of interest
All authors declare that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.

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