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Berezin et al. Vessel Plus 2020;4:15 Vessel Plus
DOI: 10.20517/2574-1209.2020.03

Review Open Access

Endothelial cell-derived extracellular vesicles in
atherosclerosis: the emerging value for diagnosis,
risk stratification and prognostication

Alexander E. Berezin , Alexander A. Berezin 2
1
1 Internal Medicine Department, State Medical University, Zaporozhye 69035, Ukraine.
2 Internal Medicine Department, Medical Academy of Post-Graduate Education, Zaporozhye 69096, Ukraine.

Correspondence to: Prof. Alexander E. Berezin, Internal Medicine Department, State Medical University for Zaporozhye,
Mayakovsky av., Zaporozhye 69035, Ukraine. E-mail: aeberezin@gmail.com
How to cite this article: Berezin AE, Berezin AA. Endothelial cell-derived extracellular vesicles in atherosclerosis: the emerging
value for diagnosis, risk stratification and prognostication. Vessel Plus 2020;4:15.
http://dx.doi.org/10.20517/2574-1209.2020.03

Received: 6 Jan 2020 First Decision: 20 Mar 2020 Revised: 23 Mar 2020 Accepted: 14 Apr 2020 Published: 16 Jun 2020
Science Editor: Narasimham L. Parinandi Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Endothelial cell-derived extracellular vesicles are produced by both activated and apoptotic endothelial cells, and
play a pivotal role in various physiological conditions such as inflammation, repair, programmed cell death, and
immune responses. There is a large body of evidence on the dysregulation of synthesis and secretion of several
types of endothelial cell-derived extracellular vesicles, which can then trigger microvascular inflammation,
atherosclerotic plaque formation, plaque rupture, thrombosis and endothelial dysfunction. The development of
atherosclerosis and cardiovascular events is associated with an increased number of apoptotic, endothelial cell-
derived vesicles and a decrease in activated, endothelial cell-derived vesicles. This review depicts the role of
endothelial cell-derived extracellular vesicles in the manifestation and progression of atherosclerosis. We also
discuss the clinical use and benefits of altering the immune phenotypes of extracellular vesicles originating from
endothelial cells, to function as predictive biomarkers in both asymptomatic and subclinical atherosclerosis.

Keywords: Atherosclerosis, cardiovascular events, extracellular vesicles, endothelial cells

INTRODUCTION
Atherosclerosis remains a leading cause of major cardiovascular events (MACEs) and cardiovascular (CV)
diseases worldwide. It represents a serious economic burden on the healthcare system and is associated
[1]
with high rates of mortality and morbidity . While there has been a steady trend towards decreasing CV
mortality from conditions associated with atherosclerosis such as stroke and myocardial infarction in

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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