Extracellular Vesicles in Neonatology: Have We Found the Magic Bullet?

Extracellular vesicles (EVs) represent nanoparticles released by numerous cell types and exerting distinct biological roles. Extracellular vesicles are enclosed in a lipid layer and contain proteins, lipids, nucleic acids, carbohydrates or even mitochondria. The fundamental utility of EVs is intercellular communication, while their implication in various biological processes, such as inflammation and hemostasis, is well-documented. Growing evidence indicates the significant usefulness of EVs as biomarkers in certain prematurity-related diseases, like bronchopulmonary dysplasia (BPD) and necrotizing enterocolitis (NEC). Moreover, many in vitro and in vivo studies have been undertaken in order to explore the potential therapeutic impact of EVs in BPD, NEC and retinopathy of prematurity (ROP), some of them yielding promising results. The present narrative review aims towards the summarization of the existing data on the application of EVs in diverse neonatal disorders, such as BPD, NEC, ROP, sepsis, multi-organ failure, coagulopathy and brain injury. The widespread investigation of EVs in neonatology and their potential implementation in clinical practice may lead towards a revolutionary approach and management of neonatal diseases, as well as an innovative perception of prematurity.