Exosomes: a common pathway for a specialized function.

Abstract

Exosomes are membrane vesicles that are released by cells upon fusion of multivesicular bodies with the plasma membrane. Their molecular composition reflects their origin in endosomes as intraluminal vesicles. In addition to a common set of membrane and cytosolic molecules, exosomes harbor unique subsets of proteins linked to cell type-associated functions. Exosome secretion participates in the eradication of obsolete proteins but several findings, essentially in the immune system, indicate that exosomes constitute a potential mode of intercellular communication. Release of exosomes by tumor cells and their implication in the propagation of unconventional pathogens such as prions suggests their participation in pathological situations. These findings open up new therapeutic and diagnostic strategies.

Full text

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J. Biochem. 140, 13–21 (2006)
doi:10.1093/jb/mvj128
JB Minireview—Membrane Traffic in
Physiology and Pathology
Exosomes: A Common Pathway for a Specialized Function
Guillaume van Niel, Isabel Porto-Carreiro, Sabrina Simoes and Gra¸ ca Raposo*
Institut Curie, CNRS-UMR144, 75248 Paris cedex, France
Received March 29, 2006; accepted April 4, 2006
Exosomesaremembranevesiclesthatarereleasedbycellsuponfusionofmultivesicular
bodies with the plasma membrane. Their molecular composition reflects their origin
in endosomes as intraluminal vesicles. In addition to a common set of membrane and
cytosolic molecules, exosomes harbor unique subsets of proteins linked to cell type–
associated functions. Exosome secretion participates in the eradication of obsolete pro-
teins but several findings, essentially in the immune system, indicate that exosomes
constitute a potential mode of intercellular communication. Release of exosomes by
tumor cells and their implication in the propagation of unconventional pathogens
such as prions suggests their participation in pathological situations. These findings
open up new therapeutic and diagnostic strategies.
Key words: ESCRT machinery, exosomes, multivesicular bodies (MVBs),
intercellular communication, ransmissible pathogens.
Abbreviations: MVBs, multi-vesicular bodies; ILVs, intra-luminal vesicles; ESCRT, endosomalsorting complex
required for transport; MHC, major histocompatibility complex; TfR, transferrin receptor; IEC, intestinal
epithelial cells; GluR 2/3, glutamate receptor subunits 2/3; Hsc, heat shock cognate; Hsp, heat shock protein;
PrP, prion protein.
Multivesicular bodies (MVBs), and their intraluminal vesi-
cles (ILVs), are involved in the sequestration of proteins
destined for degradation in lysosomes (1). An alternative
fate of MVBs is their exocytic fusion with the plasma mem-
brane leading to the release of the 50–90 nm ILVs into
the extracellular milieu (Fig. 1). The secreted ILVs are
then called exosomes (reviewed in Refs. 2 and 3). After
their initial description as vesicles of endosomal origin
secreted by reticulocytes during differentiation (4), vesicles
with the hallmarks of exosomes appeared to be released by
other cells. Exosomes are present in the culture superna-
tant of several cell types of hematopoietic origin [B cells (5),
dendritic cells (6), mast cells (7), T cells (8) and platelets
(9)] and of non hematopoietic origin [intestinal epithelial
cells (10), tumor cells (11), Schwann cells (12) and neuronal
cells (13)]. In addition there is increasing evidence
for the presence of exosomes in physiological fluids such
as plasma (14), malignant and pleural effusions (15, 16)
and urine (17).
As a consequence of proteins and lipids sorting at
the limiting membrane of endosomes during the formation
of the ILVs in MVBs, exosomes harbour a specific set of
molecules. The sorting process and the generation of ILVs
require the recognition of cargo proteins by a series of
multiprotein complexes that form the ESCRT machinery
[for review (18)] (Fig. 2). There is increasing evidence, how-
ever, that cargo sorting and MVB generation is not solely
dependent on ESCRT components. The mechanisms lead-
ing to the fusion of MVBs with the plasma membrane
and the consequent release of exosomes are unknown,
but could be reminiscent of those involved in the secretory
process of lysosome related organelles (19).
Selected cell types appear to use exosome secretion to
further their own function. Exosome release by reticulo-
cytes clears unwanted proteins and allows net loss of the
cell surface membrane, thus contributing to red blood cell
differentiation (20). Beyond this clearing function of exo-
somes, the presence of proteins with adhesion properties
(21) may confer the exosomes other roles. Phenotypical
and functional analyses of exosomes from immune cells
support the idea that these endosomal-derived vesicles
establish a cellular-independent mode of communication.
After capture, exosomes attribute new functions to the
recipient cell (reviewed in Refs. 2 and 3). Epithelial cell–
derived exosomes, through their ability to be secreted api-
cally and basolaterally, may be used for elimination of
unwanted molecules in the lumen and for the transfer of
luminalantigenicinformation
immune tissue (10).
The presence of exosomes in biological fluids such as
urine (17) and blood plasma (14) could be exploited as bio-
markers for diagnosis purposes. The ability of exosomes
from antigen presenting cells (APCs) to stimulate T cells
and to induce the eradication of tumors in mice has led
to their use as therapeutical agents for the stimulation of
anti-tumoral immune responses. Their release from tumor
cells and their presence, in vivo, in malignant effusions
(11, 15) remains puzzling as they could reveal the immu-
nogenic properties of the tumor (11, 15) despite being found
to contribute towards tumor progression (22–25). Another
role for exosomes in disease has emerged with their pos-
sible implication in the replication and propagation of
transmissible pathogens. Recent studies indicate that
the prion protein is released from cells in association
with exosomes (26). A direct implication of exosomes in
towards themucosal
Vol. 140, No. 1, 2006
13
? 2006 The Japanese Biochemical Society.
*To whom correspondence should be addressed. Structure et
Compartiments Membranaires, Institut Curie, CNRS-UMR144,
26 rue d’Ulm 75248 Paris cedex, France. Tel: +33 1 42 34 64 42,
E-mail: graposo@curie.fr

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retroviral transmission remains a plausible hypothesis
(27), however exosomes could also promote HIV trans-
infection by providing co-factors such as adhesion mole-
cules (28). The aim of this review is to describe the nature
of exosomes and demonstrate their relevance in health
and disease through highlighting several important
findings.
Generation of exosomes
Exosomes can be defined as the ILVs of MVBs once
secreted into the extracellular milieu. The ILVs which pro-
gressively accumulate during endosome maturation, are
formed by inward budding and scission of vesicles from
the limiting membrane into the endosomal lumen. During
this process, transmembrane and peripheral membrane
proteins are incorporated into the invaginating mem-
brane, maintaining the same topological orientation as
at the plasma membrane, while cytosolic components are
engulfed and enclosed into the small 50–90 nm vesicles
(Fig. 2). Exosomes from different cellular origins sequester
a common setof molecules but also display cell-type specific
components (2).
Protein composition of exosomes. The protein com-
position of exosomes purified from different sources, and in
particular fromcell culture supernatants of B lymphocytes,
DCs, intestinal epithelial cells, Schwann cells and neurons,
has been analyzed by proteomics, Facs, Western-blotting
and immunocytochemistry at the electron microscopical
level (10, 12, 13, 29, 31). This composition reflects the
cell type from which they are secreted and their endosomal
origin; as well as their possible physiological role and tar-
geting properties (reviewed in Refs. 2 and 3). Numerous
examples of cell-type specific proteins have been described:
MHC class II and class I molecules (antigen presenting
cells), transferrin receptor (TfR) (reticulocytes), A33 anti-
gen (IEC), CD3 (T cells), and the GluR2/3 subunits of
glutamate receptors (neurons). Similarly different sets of
adhesion molecules appear to reflect the cell type (integ-
rins, CAMs, tetraspanins) and end up exposed at the exo-
somal surface. Exosomes also contain common components
such as chaperones (Hsc70 and Hsp90); subunits of tri-
meric G proteins; cytoskeletal proteins (e.g., actin, tubulin,
moesin); ESCRT proteins (Tsg 101, Alix); clathrin; proteins
involved in transport and fusion (Rab 7, Rab 2, Annexins);
and several enzymes and elongation factors (reviewed in
Ref. 2). Some of these common components (Tsg 101, Alix)
are certainly involved in the generation of exosomes (see
below) but the functional significance of other proteins
(annexins, Rabs) is not fully understood.
Exosomes biogenesis. Due to the diversity of exosomal
proteins: transmembrane, peripherally associated mem-
brane proteins, cytosolic proteins and chaperones, their
sorting at the endosomal level into ILVs is thought to
involve several participants such as ESCRT components,
lipids and/or tetraspanins-enriched microdomains (Fig.
2A). Based on studies of protein sorting to ILVs of
MVBs, the sequestration of transmembrane proteins in
exosomes could require (mono)-ubiquitination and the
ESCRT machinery. This model would predict the sequen-
tial involvement of three proteins complexes (ESCRT I, II,
III) which would sort cargo proteins at the limiting mem-
brane of endosomes. This sorting is preceded by the recog-
nition of the mono-ubiquitinated cargo proteins by Hrs,
which associates in a complex with STAM, Eps15 and Cla-
thrin. Hrs recruits Tsg101 of the ESCRT I complex, that is
also able to recognize ubiquitin moieties. ESCRT I is then
thought to recruit ESCRT III via ESCRT II. Finally, the
dissociation and recycling of the ESCRT machinery
requires interaction with the AAA-ATPase Vps4. These
sequential interactions permit the sequestration of cargo
proteins into the inward budding vesicles of maturing
MVBs (for review Ref. 18). Recent studies indicate that
ESCRT II may not be directly involved in the biogenesis
of MVBs or may be redundant in the process of cargo sort-
ing, or its sorting function just limited to particular cargo
(32). The presence in exosomes of components of the
ESCRT machinery such as Alix and Tsg101 (3) and cla-
thrin (31) suggest that this machinery is implicated in the
sorting of exosomal proteins. To date, the only example of
an exosomal-associated protein that appears to require the
ESCRT components is the transferrin receptor in reticulo-
cytes. This receptor, however, is not ubiquitinated but
associates with Alix to recruit the ESCRT machinery
(33). These findings, together with observations that
other proteins not modified by ubiquitination utilize
some (Hrs, VPS4) but not all (tsg101) of the components
of the ESCRT machinery (34) imply that different protein
interactions can provide access to the final steps of ESCRT
processing.
ESCRT-independent mechanisms are also likely to oper-
ate for sorting of transmembrane cargo proteins in ILVs
of MVBs. One example is the premelanosomal protein
Pmel17 that has been shown to be present in exosomes
(11) and whose sorting to ILVs of MVBs is independent
of ubiquitination, Hrs and ESCRT I components (35). It
is also unlikely (although it cannot be excluded) that the
sorting of cytosolic and peripherally associated proteins
requires the ESCRT machinery. Sorting of cytosolic pro-
teins can be explained by a ‘‘random’’ engulfment of small
Fig. 1. MVBs fusion profile. Fusion of MVBs with the cell surface
and exosome release. Detail of an ultrathin cryosection of a B
lymphocyte double immunogold labeled for MHC class II (protein
A gold 15 nm) and MHC class I (protein A gold 10 nm). MHC class I
and class II positive exosomes are observed in the extracellular
space closely apposed to the plasma membrane (PM), Bar: 200 nm.
14G. van Niel et al.
J. Biochem.

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portions of cytosol during the inward budding process
and/or by their transient association with transmembrane
proteins. For example, the presence of chaperones such as
Hsp70 and Hsc70 in exosomes from most cells could be
driven by their co-sorting with other proteins. In agree-
ment with this, both Hsp and Hsc70 interact with the
TfR and the interaction of TfR with Hsc 70 regulates its
release via exosomes (33).
In relation to GPI-anchored proteins (for example the
Prion protein (PrP)) and other ‘‘raft’’-associated proteins
such as flotillin, stomatin or lyn; their sequestration in
exosomes, reflects the presence, in exosomal membranes,
of lipid raft-like domains. The lipid microdomains and
their components could be themselves involved in the
generation of the ILVs (36), or in concert with other pro-
teins with affinity for ‘‘raft-like domains’’ such as tetraspa-
nins. Tetraspanins interact together to form a network
in which integrins, signaling molecules or MHC II could
be incorporated. Due to their affinity for cholesterol
and sphingolipids, they form membranous microdomains
involved in adhesion, motility or signaling (37). The pre-
sence of high amounts of tetraspanins in exosomes (2,3)
suggests that recruitment of other membrane proteins
from the limiting membrane of endosomes into the ILVs
of MVBs could involve their early incorporation into
tetraspanin-containing detergent-resistant
domains (31).
Several mechanisms are thus likely to be involved in
cargo protein sorting and ILV formation. This raises the
question ofwhether theyall act jointly to generate a unique
MVB population or reveal different MVBs subpopulations.
The analysis of potentially mixed populations of exosomes
recovered from cell culture supernatants or biological
fluids cannot answer this question. Electron microscopical
observations of B lymphocytes and DCs indicate that
the content of a single MVB is heterogeneous with respect
to the morphological appearance, the size and the com-
position of the ILVs, suggesting that multiple mechanisms
membrane
cytoplasm
Internal lumen of MVB
Cytosolic protein
Cholesterol enriched domain
Tetraspanin networkGPI-anchored protein
Transmembrane protein

ESCRT machinery
Chaperone protein
Cargo embedded in the
Tetraspanin network
Biosynthetic
pathway
Endocytic
pathway
MATURATION OF MVBs FATES OF MVBs
cytoplasm
MVB
Co-sorting
By Lipid Affinity
(GPI Anchored)
Co-sorting
By Protein Affinity
(Tetraspanin network
(Chaperones
)
)
ESCRT Machinery
and associates
(cargo proteins)
Non specific
Engulfment
(cytosolic proteins)
A
B
C
1
2
3
Back
Fusion
lysosome
Plasma
membrane
Fig. 2. Biogenesis of exosomes. A: At the limiting membrane
of MVBs, several mechanism act jointly to allow specific sorting
of transmembrane, chaperones, membrane associated and cytosolic
proteins on the forming ILVs. B: Presence of several sorting
mechanisms may induce heterogeneity in the population of
ILVs in single MVBs by acting separately on different domains
of the limiting membrane. C: Receiving lipids and proteins from
the endocytic and the biosynthetic pathway, different subpop-
ulations of MVBs may be generated whose composition confers
them different fate: (1) back fusion of the ILVs with the limiting
membrane. During this process molecules previously sequestered
on the ILVs are recycled to the limiting membrane and to the
cytosol. Change in the composition of the limiting membrane
may be responsible for the tubulation allowing plasma membrane
expression of endosomal proteins. (2) Unknown mechanism may
lead MVBs toward the plasma membrane where proteins such
as SNAREs and synaptogamins would allow their fusion and
the consequent release of the ILVs in the extracellular medium
as exosomes. (3) Similarly, the composition of the limiting
membrane would preferentially induce fusion of MVBs with
lysosomes leading to the degradation of the molecules sorted on
ILVs.
Exosome Release in Physiology and Pathology
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operate in a single compartment (our unpublished obser-
vations) (Fig. 2B). On the other hand, distinct MVB popu-
lations are also likely to be generated in cells (Fig. 2C).
Independently of exosome secretion, studies on the EGF
receptor have recently shown that the receptor traffics
through a subpopulation of MVBs that are distinct from
morphologically identical vacuoles that label for lyso-
bisphosphatidic acid (LBPA) (38). Moreover, previous
findings in B lymphocytes indicate that morphologically
similar MVBs contain different amounts of cholesterol.
Interestingly those MVBs enriched for cholesterol pre-
ferentially fuse with the cell surface (39). These data
emphasize that the biogenesis of exosomes certainly
involves multiple mechanisms and the existence of
MVBs ‘‘specialized’’ for secretory purposes cannot be
excluded.
Release of exosomes. By analogy with the process of
exocytic fusion of secretory lysosomes (19), the release of
ILVs in the extracellular space requires the transport of
the formed MVB towards the cell periphery and its dock-
ing and fusion with the plasma membrane. These pro-
cesses may be dependent on Rab 11, where Rab11 acts
on the behaviour of MVBs in living cells and possibly in
the process of their secretion (40). It is not clear,
whether the effects on exosome secretion observed
with Rab11 mutants are due to the involvement of
this Rab protein in fusion events or a consequence of
the alterations of the biogenesis of MVBs. Alternatively,
the association of Rab proteins with lipids present in
MVBs, could regulate the motility of these compart-
ments. The accumulation of cholesterol in endosome
membranesincreases
membrane-associated Rab7 and inhibits the motility of
late endocytic structures (41). Therefore, sequestering
specific lipids away from the limiting membrane by sort-
ing them in ILVs, could affect the motility of the late
endosytic structures and thus the docking of MVBs with
the plasma membrane. As discussed previously, exo-
somes from different sources contain proteins involved
in membrane transport and in fusion events (Rab 5, Rab
7, ARF, rap1B, annexins). At the MVB level these pro-
teins are enclosed in ILVs, but they could be recruited to
the cytosolic side of the limiting membrane by a process
of back-fusion, which was initially proposed to occur in
DCs (42). After docking, MVBs fuse with the plasma
membrane to release their contents (Fig. 2C). This dock-
ing/fusion process is likely to be mediated by SNAREs
proteins and synaptotagmin family members. VAMP7,
Syntaxin 7 and synaptotagmin 7 are known to be impli-
cated in the fusion of ‘‘conventional’’ lysosomes with the
plasma membrane (43). It is not known whether the
exocytic fusion of MVBs is similarly modulated and/or
controlled by the same fusion machinery. Exosome
release is sensitive to changes in intracellular calcium
in mast cells (7) and in a human erythroleukemia cell
line (40). Depolarisation induced by K+
increase the secretion of neuronal exosomes (13). Cross-
linking of CD3 in T cells stimulates exosome release by
T cells but the mechanisms underlying such stimulation
are not known (8). Future work is clearly needed to
highlight the molecular mechanisms leading to the
release of exosomes, an essential step to further under-
stand their functions and significance.
theamountof
appears to
Functions of exosomes
The molecular composition of exosomes reflects the spe-
cialized function(s) of their original cells. Through their
ability to bind target cells, they are likely to modulate
selected cellular activities, such as vascular homeostasis,
and antigen presentation. The presence of exosomes in
blood and tissues in vivo, suggests their participation in
physiological and/or pathological processes. Their parti-
cular lipid composition (31) and the presence of protective
proteins against complement such as CD55 and CD59
may contribute to their stability in the extracellular
environment (44).
Exosomes from reticulocytes. Exosome release has
been demonstrated in vivo and in vitro, to be a route by
which the red cell, during maturation of reticulocytes to
erythrocytes, decreases in size and sheds specific plasma
membrane activities (20). If the cell benefits from exosome
release to undergo differentiation, the fate and role of reti-
culocyte exosomes once released is not clear. The associa-
tion of Milk Fat globule EGF factor 8 with exosomal
membranes may facilitate clearance of reticulocyte exo-
somes by phagocytes (45). The presence of decay-
accelerating factor (CD55) and membrane inhibitor of reac-
tive lysis (CD59) known to protect against complement
attack (44) or the capacity of exosomes to bind endothelial
cells through alpha4beta1 integrins/VCAM-1 interactions
(21) might confer additional functions to exosomes that
await further investigation.
Exosomes from immune cells. The presence of mole-
cules involved in antigen presentation give immune cell–
derived exosomes a status of potential modulators of the
immune response. Initial studies on B-EBV lymphocytic
cell lines highlighted the capacity of APCs to secrete exo-
somes (5). Due to the presence of MHC I and II,
co-stimulatory and adhesion molecules, B-cell exosomes
have the ability to induce antigen-specific MHC class
II–restricted T cell responses in vitro. One possible fate
of B-cell exosomes in vivo is their targeting to FDCs
in germinal centers, as illustrated by the finding that
FDCs in tonsils are likely to acquire MHC II molecules
and certainly other molecules via exosomes adsorbed at
their surface (46). In addition, B-cell exosomes express
functional integrins, which are capable of mediating
anchorage to extracellular matrix components and to
cytokine-activated fibroblasts. Notably, exosome adhesion
to TNF-alpha–activated
integrin-dependent changes in cytosolic calcium suggest-
ing that exosomes may deliver adhesion signals at dis-
tances (47).AswithB
exosomes display functional MHC class I and class II,
and accessory molecules. These exosomes are able to
prime specific cytotoxic T lymphocytes in vivo when pulsed
with tumor antigen and after injection into mice bearing
tumours although they do not have the ability to stimulate
directly T cells (6). DC-derived exosomes appear to mediate
transfer of MHC class II-peptide complexes to an ‘‘inter-
mediate’’ recipient cell, such as a neighbouring DC, then
able to activate CD4+T cells in an antigen specific manner
(48). Such transfer results in an amplification of the
immune response due to an increase in the number of
cells bearing the significant MHC–peptide complexes.
These interactions are possibly primed by the particular
sets of adhesion molecules present on exosomes and target
fibroblasts triggers
cell exosomes,DC-derived
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cells.
DC-derived exosomes to directly stimulate T cells is depen-
dent on their composition, which changes during DC
maturation. The presence of I-CAM1 in exosomes from
mature DCs appears to be essential for an indirect stimu-
lation of T cells (49). In addition to antigen presentation,
DC-derived exosomes could also support naive CD4+ T cell
survival via NF-(kappa) B activation (50). In these studies
exosomes from APCs may act directly once bound to the cell
surface or after capture by a target cell. Internalization of
exosomes by target cells is a possible mechanism under-
lying exosome capture but it is still unclear what endocytic
pathway is operating (51). It is still also unknown by which
pathway mast cell derived exosomes display mitogenic
activity on B and T cells in vitro and in vivo (52) or induce
up-regulation of PAI-1 secretion from endothelial cells
(53). T cells have also been shown to release exosomes
that could be involved in down regulation of CD3 (8).
Other studies indicate that the pro-apoptotic membrane
associated form of Fas L, can be released on T cell exo-
somes. FasL on exosomes retained its activity and was
able to trigger Fas-dependent apoptosis (54), suggesting
that exosomes could, by this way, silence an inopportune
cell response.
Exosomes in epithelia. The capacity of epithelial cells
to secrete exosomes was first described in IECs (10). Inter-
estingly, biochemical and morphological analysis showed
that exosomes were secreted from the apical and the baso-
lateral sides of the polarized cell monolayers. Both popu-
lationssharedcommon proteins
tetraspanins and Hsp, but also contain specific sets of
molecules. Apical exosomes contain syntaxin 3, microso-
mal dipeptidase CD26 and are typically addressed to the
apical membrane. Release of apical exosomes in the intest-
inal lumen suggests their involvement in a clearance pro-
cess. The presence, however, of High-mobility group box 1
(HMGB1), a cytokine-like pro-inflammatory protein, on
immunostimulated Caco-2 cell derived apical exosomes
can influence epithelial permeability (55). Basolateral exo-
somes are constitutively enriched in A33 antigen and in
MHC II molecules after activation by gIFN (56). The pre-
sence of the porous basal membrane between epithelium
and mucosal immune system suggests a role for basolat-
eral exosomes in antigen presentation independently of
direct cellular contact with effector cells. Interestingly
murine epithelial cell exosomes display immunostimula-
tory properties against food antigens when injected intra-
peritoneally (56) whereas exosome-like structures named
tolerosomes, isolated from rat IECs and serum, were
shown to induce tolerance (57). This discrepancy can be
explained by a different site of injection of exosomes in the
animal, or the activation state of the recipient cells. Tol-
erizing properties were further emphasized for exosomes
extracted from the serum containing weak amounts of
A33 antigens. However the same study also showed
that ‘‘tolerosomes’’ induce in vivo and in vitro activation
of specific T cells (57). The presence of exosomes in serum
(57) and potentially in cells entering mesenteric lymph
nodes (56) may confer the ability of static epithelial
cells to act at a distance. Exosomes of intestinal epithe-
lium seem therefore to constitute antigen-carrying struc-
tures establishing a link between luminal antigens and
Recentstudiesindicatethat thecapacity of
suchas MHCI,
the local immune system. They could act as sensors of the
antigenic information present in the intestinal lumen,
their capacity to induce immune response would be
then influenced by the inflammation.
Exosomes from other cell types. Despite the lack of
evidence for their physiological function in vivo, exosomes
appear to constitute a new way of communication shared
by an increasing number of cell types. In addition to dis-
tinct vesicles called microvesicles, platelets secrete exo-
somes; but the direct implication of these exosomes in
blood clotting awaits further studies (9). Primary cortical
neurons release vesicles with the hallmarks of exosomes
harbouring glutamate receptors (GlR2/3). Their secretion
is stimulated by depolarization, but their role is still poorly
investigated (13). Exosomes appear also to be secreted by
microglial cells. These exosomes bear the aminopeptidase
CD13, which remains active in its ability to cleave neuro-
peptides (58).
With the caution that should be given to the character-
ization of membrane vesicles as exosomes, many other
cells have been proposed to secrete exosomes or exosome-
like vesicles. Inflamed intraocular epithelia appeared to
release the target antigen hr44 and CD63 via exosomes,
which may influence the maintenance of an ocular immune
privilege (59). Kidney epithelial cells also appear to pro-
duce exosomes from their apical side, which can be recov-
ered from urine (17). Finally, salivary gland epithelial cells
(60) and the cauda epididymal region (61) have been also
described to release exosomes. So-called ‘‘Epididymo-
somes’’ could play a role in sperm epididymal maturation
by transferring P25b, which belongs to a family of sperm
surface proteins required for the binding to the surface of
the egg.
Exosomes in disease
The advantages of an exosomal-acellular mode of com-
munication should aid the development of diagnostic
and therapeutic strategies: they are non living, they con-
tain sorted sets of molecules involved in many different
cellular processes, they have the capacity to transmit
antigenic information and can be easily recovered from
fluids. Based on these properties, diagnostic protocols
and clinical assays for anti-tumoral immunotherapy are
under development. The advantages however are in detri-
ment to the potential consequences that exosomes pose to
human health, where exosomes may be used by tumoral
cells to invade normal tissue, and by pathogens such as
prions and HIV to maximise their spreading in between
cells.
Exosomes in diagnosis and therapies. The presence
inaccessible fluids(blood
broncho-alveaolar lavage fluid) of exosomes containing bio-
markers, is already exploited in clinical studies and may
be useful for early detection of a disease status. Hundreds
of proteins, including multiple protein products of genes
already known to be responsible for renal and systemic
diseases such as aquaporin-2 have been found in exosomes
isolated from urine (17).
A potential approach to cancer immunotherapy based on
exosomes has arisen from initial studies showing that
DC-derived exosomes loaded with tumor peptides are cap-
able of priming cytotoxic T cells and can mediate the
plasma,urineor
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rejection of tumours expressing the relevant antigens in
mice (6). These ‘‘Dexosomes’’ also promote NK cell activa-
tion in immunocompetent mice and NK cell–dependent
anti-tumor effects. Based on these results, clinical trials
are in progress (62). Vaccination strategies could also be
envisioned using exosomes from tumor cells that carry
tumor antigens (11, 63). By using different sources of
tumour exosomes such as Plasmacytoma cells–derived exo-
somes (64), several groups have shown that exosomes can
induce tumor-specific immunity, prevent tumor develop-
ment and are a potential strategy for future therapeutic
tumour vaccination.
Some novel properties of exosomes were recently
described which included the suppression of inflamma-
tory and autoimmune responses induced by IL10-treated
immature DCs derived exosomes (65) and protection
againstinfectionwith T.
exosomes (66). Therefore innovative strategies based
on exosomes could emerge in the forthcoming years
for developing a broad range of novel diagnostics and
therapeutics.
Exosomes in cell transformation. The biological sig-
nificance of exosome secretion by tumor cell lines, and the
presence of exosomes in malignant effusions is not clear
(11, 15). Despite their immunogenic properties when cap-
tured by DCs (11), tumoral exosomes may also favour
tumorinvasion(25,
67).
NKG2D ligands decrease the capacity of CD8+ T cells
to kill target cells (22). This discrepancy can be attributed
to the presence of DCs in the vicinity of exosomes or to the
presence of Hsp with activating properties on exosomes
(68). Similarly, LMP1, an EBV protein, was found
on exosomes from EBV-positive tumor cells. This protein
mediates immunosuppressive effects on tumor-infiltrating
lymphocytes and LMP1-containing exosomes were shown
to inhibit the proliferation of peripheral blood mononuc-
lear cells (23). Exosomes could also support tumor cell
survival by promoting their invasive properties. The pre-
sence on mesothelioma cell–derived exosomes of a strong
angiogenic factor (developmental endothelial locus-1 or
DEL-1) could participate in the vascular development
in the neighbourhood of the tumor (24). Other mechan-
isms contributing to cancer immune evasion have been
described. Tumor-derived
IL2-mediated activation of NK cells (69) or induce
FasLigand-mediated T-cell
studies should warrant further investigations considering
that the composition of exosomes may determine the
capacity of tumor exosomes to induce anti tumor-immune
response (68).
Exosomes and prions. The finding that the cellular
PrP (PrPc) and its scrappie isoform (PrPsc) are associated
with exosomes together with the proposal that exosomal
membranes constitute a mean of intercellular communi-
cation, opens the possibility that exosomes may poten-
tially participate in the propagation of this unusual
infectious agent (26). Based on Western blot, mass spec-
trometry and morphological analysis, PrPc and PrPsc in
the cell culture supernatants of PrP-expressing rabbit kid-
ney epithelial cells and Schwann cells appeared to be
associated with exosomes. Furthermore, PrPsc-containing
exosomes inoculated in transgenic mice induced a typical
neurological disorder (12). Recent studies on platelets are
gondii-pulsed DC-derived
Tumorexosomes bearing
exosomescouldblock
apoptosis(67). These
also suggestive of such a role for exosomes in prion dis-
eases (70). Exosome delivery from infected to recipient
non-infected cells could be relevant to understanding
the transconformation process. First the raft-like nature
of exosomal membranes (31) could be a favourable envir-
onment for transconformation and amyloid fiber forma-
tion. Second, it has been reported that conversion of
PrPc into PrPsc is greatly facilitated when the cellular
and the transconformed PrP proteins are in contiguous
rather than in facing membranes. Exchange of mem-
branes can result in insertion of incoming PrPsc into
the raft domains of recipient cells and exosomes bearing
PrPsc released from infected cells could undergo fusion
with the plasma membrane of non-infected cells (reviewed
in Ref. 26). Perhaps a more likely scenario would involve
internalization of exosomes and fusion with endosomal
limiting membranes, similar to the process of back
fusion of the internal vesicles of MVBs reported to
occur in DCs (42).
Exosomes and virus. HIV-1 and other retroviruses
accumulate in compartments with features of late endo-
somes/MVBs because of their ability to exploit the machin-
ery of MVBs generation. Retroviruses and ILVs/Exosomes
share several characteristics with relation to their compo-
sition and both are released into the extracellular milieu
upon fusion of ‘‘hijacked’’ MVBs with the cell surface
(reviewed in Ref. 27). A direct implication of exosomal
membranes in HIV infection is not clear but recent obser-
vations indicate that HIV particles captured by DCs are
internalized into MVB-like compartments (71) and are able
to be transmitted to T cells by exocytosis without de novo
infection. Productive infections of CD4(+) target cells could
be facilitated by an association of HIV particles with
exosome-like vesicles (28).
Concluding remarks
In recent years a wide range of regulatory functions
have been attributed to membrane vesicles with the hall-
marks of exosomes. The identification of vesicles as exo-
somes is based on both morphological and biochemical
criteria although particular attention should be given to
the purification and characterization methods. Exosomes
are the ILVs of MVBs and are thus endosome-derived
membrane vesicles. An ‘‘exosomal-type’’ of communication
is certainly not limited to the immune system and may be
exploited by cells to interact with each other, locally or at a
distance. Highlighting the cellular and molecular basis of
exosome targeting to recipient cells will be invaluable to
understand how different populations of exosomes main-
tain their own specificity. Exosome biogenesis is still far
from being well understood and the mechanisms involved
in the fusion of ‘‘secretory’’ MVBs with the plasma mem-
brane are unknown. In the forthcoming years, light
should be shed on the mechanisms regulating these pro-
cesses so that methods can be designed to interfere with
exosome secretion. With this advance, much more could
be discovered on how exosomes function in physiological
and pathological situations.
We are grateful toM. Morgan (Institut Curie, CNRS-UMR144)
for reading the manuscript. We apologize to those authors
whose work we were unable to reference owing to restrictions
in the length and reference numbers.
18G. van Niel et al.
J. Biochem.

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