Recently, extracellular vesicles (EVs), like exosomes and microvesicles, have attracted attention as
potent carriers of intercellular communication throughout the body, including the brain. They transmit biological
signals from donor cells to recipient cells, and recent evidence suggests that they may even carry such signals to
distant destinations through peripheral circulation. In the central nervous system (CNS), EVs contribute to maintaining
normal neuronal function, as well as to the pathological development of neurodegenerative diseases. Although
some evidence has suggested that EVs can cross the blood-brain barrier (BBB), moving from the peripheral
circulation to the CNS, the mechanisms by which EVs facilitate communication between peripheral tissues
and the CNS are not well understood. The BBB is a dynamic interface that regulates molecular trafficking between
the peripheral circulation and the CNS. However, there is limited mechanistic understanding of how bloodborne
EVs cross the BBB under physiological and pathological conditions. In this review, we focus on current
knowledge of trafficking of EVs between the peripheral circulation and the brain. Moreover, we describe hypothetical
transport routes by which EVs may cross the BBB based on previous reports. Further investigation is
needed to understand the precise mechanisms by which EVs are transported across the BBB.
Keywords: Adsorptive-mediated transcytosis (AMT), blood-brain barrier (BBB), extracellular vesicles (EVs), endothelial cell, exosome, neurodegenerative
disease, Parkinson’s disease (PD), receptor-mediated transcytosis (RMT).
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