Exosome-Like Vesicles as New Mediators and Therapeutic Targets for Treating Insulin Resistance and β-Cell Mass Failure in Type 2 Diabetes Mellitus

Figure 2

Schematic illustration of how exosome-like vesicles (ELVs) serve as mediators and therapeutic targets for treating insulin resistance (IR) and β-cell mass failure in type 2 diabetes. Type 2 diabetes-associated pathologic conditions (such as high glucose, inflammation, hypoxia, and high fatty acids) modify the quantity and components of ELVs secreted from the pancreas or peripheral insulin-targeting tissues. These released ELVs may either enter into the circulation or enter neighboring cells or macrophages, delivering IR or β-cell apoptosis signatures. ELVs released by mesenchymal stem cells (MSCs) can improve insulin sensitivity and enhance β-cell proliferation. Red arrows indicate stimulation or activation; green blunted arrows indicate inhibition.