A recently discovered communication system used by cells to send messages across the human body promises to revolutionize our understanding of disease and how we treat it. Technologies based on this discovery promise to become important tools for our understanding, monitoring and treatment of some of man's most insidious diseases such as cancer. The key elements comprising this communication system are nano and micron sized vesicles often called exosomes or extracellular vesicles (EVs), which are the carriers of the molecular information.
 
Exosomes and EVs are produced by most if not all cell types, under normal conditions and especially in response to disease.  Exosomes and EVs are expelled from affected cells and circulate in various bodily fluids including blood, urine and saliva. Importantly, circulating exosomes share certain molecular structures and components in common with their parental cells, including DNA, RNA and Proteins. Exosomes shuttle this molecularly encoded information between cells and across distances, effectively acting as the body's molecular internet. 
                                       
By gathering exosomes via a simple blood draw, information can be accessed representing distant cells, tissues and organs, including information originating from a multitude of diverse diseases such as cancer, Alzheimer's, arteriosclerosis, arthritis, diabetes, and multiple sclerosis (MS) among many others. Unlike invasive tissue biopsies exosomes can be easily collected and interrogated serially. This dynamic accessibility would allow for screening and early detection of disease, monitoring of progression, drug response, recurrence and resistance. Not merely a blue sky technology, exosome and EVs are contributing to personalized and precision medicine today as research tools and may be available for first clinical applications as early as this year.  
 
Learning objectives:
1) understand the origins of exosomes and EVs  
2) understand the application of exosomes and EV for disease monitoring.