The release of extracellular vesicles (EVs) from cells has been a recent area of extensive study in basic biology.1,2 Extracellular vesicles are considered to be a vital means of communication and molecular signaling used by many cell types, and EVs accomplish these tasks by delivery of cargoes carrying nucleic acids (eg, noncoding RNAs), proteins, and metabolites. The most prominent established role of EVs in neurology thus far is in biomarker development.3 Recent studies4,5 have found that many serum or cerebrospinal fluid biomarkers, such as neurofilament light, tau, and others (historically measured directly from unfractionated fluids) actually reside in EVs, implying that these insoluble cytoplasmic proteins are probably generated from sick or injured cells and then released within EVs as cargo.
Dubal DB, Pleasure SJ. Neural-Derived Extracellular Vesicles in Clinical Trials: Message in a Bottle. JAMA Neurol. 2019;76(4):402–404. doi:10.1001/jamaneurol.2018.4325
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