Boonkaew B, Charoenthanakitkul D, Suntornnont N, Ariyachet C, Tangkijvanich P. Extracellular vesicles in metabolic dysfunction-associated steatotic liver disease: From intercellular signaling to clinical translation. World J Hepatol 2025; 17(9): 108259 [DOI: 10.4254/wjh.v17.i9.108259]
Corresponding Author of This Article
Chaiyaboot Ariyachet, Assistant Professor, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, 1873 Paettayaphat Bldg, Rama IV Road, Bangkok 10330, Thailand. chaiyaboot.a@chula.ac.th
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Bootsakorn Boonkaew, Denita Charoenthanakitkul, Nuchanart Suntornnont, Chaiyaboot Ariyachet, Pisit Tangkijvanich, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Bootsakorn Boonkaew, Denita Charoenthanakitkul, Nuchanart Suntornnont, Chaiyaboot Ariyachet, Pisit Tangkijvanich, Center of Excellence in Hepatitis and Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Author contributions: Boonkaew B and Ariyachet C conceptualized the study and reviewed and edited the various versions of the paper; Boonkaew B, Charoenthanakitkul D, and Ariyachet C wrote the original draft of the paper; Suntornnont N generated the data visualization images; Tangkijvanich P supervised the project; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chaiyaboot Ariyachet, Assistant Professor, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, 1873 Paettayaphat Bldg, Rama IV Road, Bangkok 10330, Thailand. chaiyaboot.a@chula.ac.th
Received: April 9, 2025 Revised: May 18, 2025 Accepted: August 13, 2025 Published online: September 27, 2025 Processing time: 169 Days and 18.5 Hours
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) poses a substantial global health burden, progressing from simple steatosis to metabolic dysfunction-associated steatohepatitis and cirrhosis. A deeper understanding of the underlying mechanisms and associated complications is crucial for developing effective therapies. Extracellular vesicles (EVs), nanoscale membrane-enclosed particles carrying bioactive cargoes such as proteins and noncoding RNAs, including microRNAs and long noncoding RNAs, play crucial roles in intercellular communication and have emerged as critical mediators of MASLD pathogenesis. This article details the current understanding of the function of EVs in MASLD progression, emphasizing specific cell-derived EVs implicated in disease development. We elucidate how EVs facilitate intercellular communication and influence key pathological processes, including lipotoxicity, inflammation, and fibrosis. Furthermore, we examine the involvement of EVs in MASLD-associated complications and evaluate their potential as minimally invasive tools for disease diagnosis, staging, and prognosis. We also explore EV-based therapeutic strategies, encompassing preclinical studies, while acknowledging current challenges and future opportunities. Finally, we discuss emerging research trends, the potential for personalized medicine, and areas necessitating further investigation, particularly the utilization of EVs as therapeutic targets or delivery vehicles. This review underscores the pivotal role of EVs in MASLD, providing insights into their translational potential for improved patient outcomes.
Core Tip: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern that progresses from simple steatosis to cirrhosis. Extracellular vesicles (EVs) have emerged as key mediators of MASLD pathogenesis, influencing lipotoxicity, inflammation, and fibrosis through bioactive cargoes such as microRNAs. This review highlights the role of EVs in MASLD progression, their diagnostic and prognostic potential, and EV-based therapeutic strategies. We also address current challenges, emerging research trends, and future perspectives, emphasizing the translational potential of EVs for improving patient outcomes.
