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Reiss et al. Vessel Plus 2020;4:19 Vessel Plus
DOI: 10.20517/2574-1209.2020.04

Review Open Access

Obesity and atherosclerosis: the exosome link

Allison B. Reiss, Daniel S. Glass, Iryna Voloshyna, Amy D. Glass, Lora J. Kasselman, Joshua De Leon
Department of Medicine and Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA.

Correspondence to: Dr. Allison B. Reiss, Department of Medicine, NYU Long Island School of Medicine, 101 Mineola Boulevard
Suite 4-004, Mineola, NY 11501, USA. E-mail: allison.reiss@nyulangone.org

How to cite this article: Reiss AB, Glass DS, Voloshyna I, Glass AD, Kasselman LJ, De Leon J. Obesity and atherosclerosis: the
exosome link. Vessel Plus 2020;4:19. http://dx.doi.org/10.20517/2574-1209.2020.04
Received: 16 Jan 2020 First Decision: 2 Mar 2020 Revised: 15 Apr 2020 Accepted: 28 Apr 2020 Published: 12 Jul 2020

Academic Editor: Nicola Ferri Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Obesity is a global public health issue with serious health consequences and rising prevalence. It is a risk factor for
a broad range of diseases, particularly atherosclerosis and cardiovascular disease. Long-term weight loss is difficult
to achieve, even with diet, life-style changes and anti-obesity drugs. The causes of the association between obesity
and atherosclerotic cardiovascular disease are the subject of ongoing investigation. It is known that a chronic
surplus in nutritional intake results in expansion and remodeling of adipose tissue, leading to chronic inflammation.
Lipid overloaded adipocytes secrete pro-inflammatory adipokines and other mediators that produce this
inflammatory state that may in turn, promote atherosclerosis, which is considered an inflammatory disorder. This
review discusses the potential role of exosomes from adipose tissue in accelerating atherosclerosis in the setting of
obesity. Exosomes are small membrane-bound vesicles that circulate in body fluids and are important participants
in intercellular communication both locally and at a distance. They can transfer their cargo of protein, DNA, RNA
and microRNA between cells, thus impacting cellular function and signaling. Adipose tissue-derived exosomes may
be involved in heightening of the atherogenic environment and, if so, suggests a therapeutic target for the treatment
and prevention of cardiovascular complications of obesity.

Keywords: Obesity, atherosclerosis, adipocyte, macrophage, exosome

INTRODUCTION
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality
[1-3]
worldwide . Obesity increases the risk of ASCVD and death even after accounting for other known risk
[4]
factors such as dyslipidemia, smoking, and hypertension . The underlying mechanisms that produce the
added harmful effects of obesity are poorly understood. Elucidating the mechanisms behind differences
[5,6]
between obese individuals with and without atherosclerosis could reveal therapeutic targets for treating
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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