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Amyotrophic lateral sclerosis-associated toxic exosomes (ALS-exosomes) (ALS-exosomes)

Target
ALS-exosomes
Molecular classification
Extracellular vesicle, Exosome
01

Overview

Amyotrophic lateral sclerosis-associated toxic exosomes (ALS-exosomes) are specialized extracellular vesicles, typically 30–150 nm in diameter, that are secreted by neurons and glial cells and play a pivotal role in the pathogenesis of ALS (Basso et al., 2013). These vesicles encapsulate and transport neurotoxic cargo, including misfolded proteins such as TDP-43, SOD1, and FUS, as well as pathogenic microRNAs, from diseased cells to healthy neighboring cells (Iguchi et al., 2016). This mechanism facilitates the prion-like propagation of protein aggregates throughout the central nervous system, which is a hallmark of disease progression (Silverman et al., 2019). Furthermore, these toxic exosomes can induce inflammatory responses in microglia and astrocytes, creating a neurotoxic environment that further accelerates motor neuron death (Pinto et al., 2017). From a therapeutic perspective, ALS-exosomes are being targeted through the inhibition of their biogenesis using small molecules like GW4869 or through the development of antibodies designed to neutralize them in the extracellular space (Gomes et al., 2020). They also represent significant potential as liquid biopsy biomarkers, as their molecular contents reflect the pathological state of the central nervous system (Thompson et al., 2020).

Other names
ALS-derived extracellular vesiclesALS-EVsPathogenic extracellular vesicles in ALSTDP-43-containing exosomes
02

Mechanism of action

Inhibition of neutral sphingomyelinase 2 (nSMase2) to reduce exosome biogenesis; blockade of Rab GTPase-mediated vesicle secretion; antibody-mediated sequestration and clearance of circulating toxic vesicles

03

Biological functions

Intercellular communicationProtein transportPathological seedingNeuroinflammation
04

Disease associations

Amyotrophic lateral sclerosisFrontotemporal dementiaNeurodegenerative disease
05

Safety considerations

Potential impairment of physiological intercellular signalingRisk of systemic side effects from non-specific inhibition of vesicle releaseChallenges in achieving therapeutic concentrations across the blood-brain barrier
06

Interacting drugs

GW4869

3 more in the full profile.

07

Biomarkers

Exosomal TDP-43Exosomal pTDP-43Exosomal SOD1miR-124Neurofilament light chain (NfL)

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