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Mathew et al. Vessel Plus 2020;4:11 Vessel Plus
DOI: 10.20517/2574-1209.2019.35

Review Open Access

Microvesicles and exosomes in pulmonary
hypertension

Rajamma Mathew , Thambi Dorai 2
1
1 Departments of Pediatrics and Physiology, New York Medical College, Valhalla, NY 10595, USA.
2 Deapertments of Urology and Biochemistry and Molecular Biology, New York Medical College, Valhalla, NY 10595, USA.
Correspondence to: Dr. Rajamma Mathew, Basic Science Building, New York Medical College, 15 Dana Road, Valhalla, NY 10595,
USA. E-mail: rmathew@nymc.edu
How to cite this article: Mathew R, Dorai T. Microvesicles and exosomes in pulmonary hypertension. Vessel Plus 2020;4:11.
http://dx.doi.org/10.20517/2574-1209.2019.35
Received: 23 Dec 2019 First Decision: 25 Feb 2020 Revised: 1 Apr 2020 Accepted: 14 Apr 2020 Published: 11 May 2020
Science Editor: Narasimham L. Parinandi Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Pulmonary hypertension is a serious disorder with a high morbidity and mortality rate. The juxtaposition of
endothelial cells and smooth muscle cells maintains vascular homeostasis. Vascular injury results in endothelial
dysfunction, leading to impaired vascular relaxation, cell proliferation, and altered immune and metabolic states. In
addition, injury induces pulmonary arterial endothelium and other cells to release increased levels of extracellular
vesicles, including exosomes and microparticles that may be involved in enhancing the proliferation of apoptosis-
resistant smooth muscle cells. These extracellular vesicles carry proteins, lipids, RNA, miRNA, chemokines
cytokines and modulate immune function, inflammation, embryogenesis, regenerative processes, and serve as
intercellular messengers. Importantly, mesenchymal stem cells-derived extracellular vesicles exert inhibitory
effects on inflammation and restore homeostasis. This article reviews the pathophysiological role of extracellular
vesicles in pulmonary hypertension.

Keywords: Endothelial cells, extracellular vesicles, mesenchymal cells, pulmonary hypertension

INTRODUCTION
Pulmonary hypertension (PH) is a serious complication of a number of systemic diseases including
cardiovascular, respiratory and hematological disorders, autoimmune diseases, genetic mutations, and as
yet unidentified causes. Based on the underlying disease, PH can be classified into five major groups. The
term pulmonary arterial hypertension (PAH) is applied to diseases in group 1, which includes idiopathic
and heritable PAH (IPAH, HPAH), and PAH associated with congenital heart defects, inflammation,
autoimmune diseases and drug toxicity. A number of genetic mutations are also associated with PAH.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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