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EV0994

Do exosomes have the potential to contribute to current psychiatric practice, and what could they offer?

DO EXOSOMES HAVE THE POTENTIAL TO AID CURRENT PSYCHIATRIC PRACTICE, AND WHAT DO THEY HAVE TO OFFER?

Exosomal miRNA analysis has the potential to contribute to psychiatric diagnosis, but inconsistencies across studies mean that the method is not yet reliable enough to guide clinical assessment.

The aim of this review is to critically evaluate research on exosomal analysis and examine the potential of this technique to support the diagnosis and treatment of psychiatric disorders. Exosomes are a subtype of extracellular vesicles that circulate among all cells in the body, and the microRNAs (miRNAs) they contain can be extracted and analyzed using various methods; abnormal levels of specific miRNAs have been associated with functional impairments in the host cell. The review included 10 articles retrieved from the Medline and SCOPUS databases. Studies published between 2017 and July 9, 2025, covering bipolar disorder, unipolar disorder, major depressive disorder, Alzheimer’s disease, and suicidal behaviors were deemed eligible, and the CASP (2022) tool appropriate to each study design was used for quality assessment. The findings were listed by disorder in a table: in bipolar/unipolar disorder (four studies), levels of miR-184, 196a-5p, 128-3p, 195-5p, 382-5p, 487b-3p, 744-3p, 19b-3p, and 149 were increased, while levels of miR-10b-5p, 10b-3p, and 874-5p were decreased; in major depressive disorder (three studies), levels of miR-16, 376b, 139-5p, 155, 345-5p, 146a, 674, 708, 133a, 335-5p, 1292-3p, let-7b, and let-7c were reported to be increased, while levels of miR-151a-3p, 218, and 511 were decreased. In Alzheimer’s disease (one study), levels of miR-451a, 21-5p, 23a-3p, 126-3p, let-7i-5p, and 151a-3p were decreased; in suicidal behaviors (two studies), numerous miRNAs were reported to show both increases and decreases. Some miRNAs were implicated in more than one condition or were reported as both increased and decreased in the same condition. In conclusion, although exosomal analysis has the potential to complement existing diagnostic procedures, there is considerable inconsistency among the findings, and the method is not yet sufficiently developed to provide reliable results that can guide psychiatric assessment; future studies are recommended to focus on a specific cohort or a single analytical method.

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