Перспективы использования экзосом опухолевых клеток в диагностике, мониторинге и терапии злокачественных заболеваний

Development of non-invasive methods of studying of exosomes, containing nucleic acids and specific proteins of tumor cells for screening, early diagnostics and monitoring of tumor growth, is the actual problem of oncology. This is important both for primary diagnostics of malignant diseases and for control of metastatic processes, which are the key moment for control of latent tumor stem cells, starting the proliferation and leading to lethal outcome after years and decades after typing of primary tumor. Exosomes, extracted from the tumor cells of biological fluids, malignant exudates and dendritic cells of oncological patients, are the close copies of receptors, proteins and nucleic acids of initial cells, which have the immune modulating activity and able to represent antigens by stimulating of antigen-specific T-cells answer. Therapeutic potential of exosomes studying now in case of infections, which pathogens persist in cells of immune system (toxoplasmosis, tuberculosis, severe acute respiratory syndrome), tumors, autoimmune and autoinflammatory diseases. Experimental data indicate that exosomes, containing antigens of malignant cells, inhibit tumor growth by induction of T-cell specific immune answer, leading to tumor regression in experimental animal models. Transferring of results of study of therapeutic activity of exosomes from mice to humans is impossible due to difference in immune system of human and mouse. However, usage of exosomes in phase I of clinical trials in different oncological diseases showed that therapy with exosomes is safe, non-toxic, well-tolerated, can effectively be combined with colony stimulating factors, inducting congenital and adaptive immune answer, stabilizing disease and provides prolonged surviving for a number of patients. There are also the opposite data on suppressive effect of exosomes on activity of effector cells and, therefore, possible acceleration of tumor growth. General tendency of development of therapeutic studies largely repeats experience of usage of anti-cancer vaccines and it’s relationship with chemotherapy and target immune therapy of malignant disorders. This review reflects diagnostic and therapeutic options of exosomes tumor cells and possibility of usage in monitoring and treatment of malignant disorders of human.