DNA in extracellular vesicles: biological and clinical aspects

The study of extracellular vesicles (EVs), especially in the liquid biopsy field, has rapidly evolved in recent years. However, most EV studies have focused on RNA or protein content and DNA in EVs (EV-DNA) has largely been unnoticed. In this review, we compile current evidence regarding EV-DNA and provide an extensive discussion on EV-DNA biology. We look into EV-DNA biogenesis and mechanisms of DNA loading into EVs, as well as describe the particularly significant function of DNA-carrying EVs in the maintenance of cellular homeostasis, intracellular communication, and immune response modulation. We also examine the current role of EV-DNA in the clinical setting, specifically in cancer, infections, pregnancy and pre-natal diagnosis.