Exosomes are nano‐sized extracellular vesicles containing a cell‐specific biologically active cargo of proteins and genetic materials. Exosomes are constitutively released from almost all cell‐types and affect neighboring or distant cells through a complex intercellular exchange of the genetic information and/or regulation of certain gene expressions that change the function and behavior of recipient cells. Those released into body fluids are the major mediators of intercellular communications. The success of the biological functions of exosomes is highly mediated by the effective transfer of microRNAs (miRs). Exosomes secreted by a damaged or diseased heart can exhibit alterations in the miRs' profile that may reflect the cellular origin and (patho)physiological state, as a “signature” or “fingerprint” of the donor cell. It has been shown that the transportation of cardiac‐specific miRs in exosomes can be rapidly detected and measured, holding great potential as biomarkers in heart diseases. Currently, the search for new biomarkers of heart diseases remains a large and increasing enterprise. Notably, circulating exosomal miRs (Exo‐miRs) have successfully gained huge interests for their diagnostic and prognostic potentials. The present review highlights circulating Exo‐miRs explored for diagnosis/prognosis and outcome prediction in patients with heart failure (HF). To this end, we explain the feasibility of exosomes as clinical biomarkers, discuss the priority of circulating Exo‐miRs over non‐exosomal ones as a biomarker, and then outline reported circulating Exo‐miRs having the biomarker function in HF patients, together with their mechanism of action. In conclusion, circulating Exo‐miRs represent emerging diagnostic (Exo‐miR‐92b‐5p, Exo‐miR‐146a, Exo‐miR‐181c, and Exo‐miR‐495) and prognostic (Exo‐miR‐192, Exo‐miR‐194, Exo‐miR‐34a, Exo‐miR‐425, Exo‐miR‐744) biomarkers for HF.

中文翻译：

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循环外泌体微RNA作为新兴的心力衰竭非侵入性临床生物标志物：纳米生物颗粒的巨大生物作用

外泌体是纳米级的细胞外囊泡，含有细胞特异性的生物活性蛋白质和遗传物质。外泌体从几乎所有细胞类型中组成性释放，并通过遗传信息的复杂细胞间交换和/或某些改变受体细胞功能和行为的基因表达的调节来影响邻近或远处的细胞。那些释放到体液中的物质是细胞间通讯的主要介质。外泌体生物学功能的成功在很大程度上是由微小RNA（miR）的有效转移所介导的。受损或患病心脏分泌的外泌体可以表现出 miRs 谱的改变，这可能反映细胞起源和（病理）生理状态，作为供体细胞的“签名”或“指纹”。研究表明，可以快速检测和测量外泌体中心脏特异性 miRs 的转运，具有作为心脏病生物标志物的巨大潜力。目前，寻找新的心脏病生物标志物仍然是一项庞大且不断增加的事业。值得注意的是，循环外泌体 miR（Exo-miRs）因其诊断和预后潜力而成功获得了巨大的兴趣。本综述重点介绍了循环 Exo-miR 用于心力衰竭 (HF) 患者的诊断/预后和结果预测。为此，我们解释了外泌体作为临床生物标志物的可行性，讨论了循环 Exo-miRs 作为生物标志物的优先级，然后概述了在 HF 患者中具有生物标志物功能的循环 Exo-miRs，以及它们的作用机制。