Abstract

Exosomes, as integral mediators of cellular communication, have emerged as crucial 
players in the pathogenesis and potential treatment of autoimmune diseases. This review 
explores the dual role of exosomes in mediating autoantigen presentation and their 
impact on immune dysregulation. Exosomes, by virtue of their cargo—comprising 
proteins, peptides, and nucleic acids—can influence immune tolerance, potentially 
leading to the breakdown of self-tolerance and the perpetuation of autoimmune 
responses. They carry and present autoantigens directly to T cells or indirectly via 
antigen-presenting cells, thereby initiating and sustaining immune reactions 
characteristic of autoimmune disorders. Furthermore, the review delves into the 
therapeutic implications of targeting exosomal pathways, discussing strategies such as 
inhibiting exosome biogenesis, modifying exosomal content, and blocking exosome 
uptake by immune cells. Such interventions present promising avenues for developing 
novel treatments aimed at mitigating autoimmune responses. By harnessing the unique 
properties of exosomes, future research may pave the way for innovative therapeutic 
strategies that offer more precise and personalized treatment options for patients 
suffering from autoimmune diseases.