Role of retinal pigment epithelium-derived extracellular vesicles in the pathogenesis of age-related macular degeneration

Age-related macular degeneration (AMD) is one of the main causes of irreversible vision loss in the elderly worldwide.Its main pathological features are the degeneration of retinal pigment epithelium (RPE) and the irreversible damage or loss of photoreceptor cells.Extracellular vesicles (EVs) are a class of heterogeneous nanovesicles with lipid bilayer membranes, including exosomes, microvesicles and apoptotic bodies, which exert biological effects by transmitting molecules such as RNA and protein.In this review, RPE-derived extracellular vesicles (RPE-EVs) are involved in the regulation of oxidative stress, inflammation, and neovascularization in AMD.RPE-EVs derived Apaf1, HDAC6, miR-494-3p, miR-138-5p, miR-21, miR-543 and miR-302a-3p can be used as candidate molecular targets for the diagnosis and treatment of AMD, but their mechanisms of action have not been elucidated.Due to the unique advantages of high biocompatibility, low immunogenicity, low toxicity, targeting, stability, and specificity of RPE-EVs, it is necessary to further study the role of RPE-EVs in the pathogenesis of AMD, and focus on the role of RPE-EVs in the diagnosis and treatment of AMD, so as to realize the clinical transformation of RPE-EVs, and open up new ways for the diagnosis and treatment of AMD.

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