Emerging biomarkers in liquid biopsy: the small extracellular vesicles

Small extracellular vesicles (sEVs) (30-150 nm) are actively released by cells into biological fluids, playing a crucial role in intercellular communication. They carry a complex cargo of proteins, lipids, and nucleic acids, which closely reflect the physiological and pathological state of their cells of origin. In recent years, sEVs have emerged as promising biomarkers in liquid biopsy due to their stability, abundance, and ability to provide molecular information on various diseases, including cancer, neurodegenerative disorders, and inflammatory conditions. This manuscript explores the potential of sEVs as non-invasive biomarkers for early disease detection, prognosis, and treatment monitoring. We discuss their advantages over traditional biopsy techniques, such as their capacity to capture tumor heterogeneity and provide real-time molecular insights. Additionally, we analyze recent advances in sEVs isolation and characterization technologies, which are essential for their clinical application. Despite their promise, several challenges remain, including standardization of isolation methods, scalability for clinical use, and regulatory considerations. Addressing these hurdles will be key to integrating sEVs - based biomarkers into routine clinical practice. Overall, sEVs represent a novel and powerful tool for precision medicine, offering new opportunities for early diagnosis and personalized therapeutic strategies. Future research should focus on improving analytical methodologies and validating sEVs - based biomarkers in large-scale clinical studies to fully unlock their diagnostic and prognostic potential.