<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Terapevticheskii arkhiv</journal-id><journal-title-group><journal-title xml:lang="en">Terapevticheskii arkhiv</journal-title><trans-title-group xml:lang="ru"><trans-title>Терапевтический архив</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0040-3660</issn><issn publication-format="electronic">2309-5342</issn><publisher><publisher-name xml:lang="en">LLC Obyedinennaya Redaktsiya</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">707086</article-id><article-id pub-id-type="doi">10.26442/00403660.2026.08.203786</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Editorial article</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Передовая статья</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Еxosomes: possibilities and prospects in the diagnosis and treatment of digestive diseases</article-title><trans-title-group xml:lang="ru"><trans-title>Экзосомы: возможности и перспективы в диагностике и лечении заболеваний органов пищеварения</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6114-564X</contrib-id><name-alternatives><name xml:lang="en"><surname>Maev</surname><given-names>Igor V.</given-names></name><name xml:lang="ru"><surname>Маев</surname><given-names>Игорь Вениаминович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>акад. РАН, д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии </p></bio><email>gaus_olga@bk.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6581-7017</contrib-id><name-alternatives><name xml:lang="en"><surname>Livzan</surname><given-names>Maria A.</given-names></name><name xml:lang="ru"><surname>Ливзан</surname><given-names>Мария Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>чл.-кор. РАН, д-р мед. наук, проф., зав. каф. факультетской терапии и гастроэнтерологии, ректор </p></bio><email>gaus_olga@bk.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9370-4768</contrib-id><name-alternatives><name xml:lang="en"><surname>Gaus</surname><given-names>Olga V.</given-names></name><name xml:lang="ru"><surname>Гаус</surname><given-names>Ольга Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="ru"><p>д-р мед. наук, доц., проф. каф. факультетской терапии и гастроэнтерологии </p></bio><email>gaus_olga@bk.ru</email><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Russian University of Medicine</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Российский университет медицины» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Omsk State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2026-08-18" publication-format="electronic"><day>18</day><month>08</month><year>2026</year></pub-date><volume>98</volume><issue>8</issue><issue-title xml:lang="en">Treatment issues</issue-title><issue-title xml:lang="ru">Вопросы лечения</issue-title><fpage>432</fpage><lpage>438</lpage><history><date date-type="received" iso-8601-date="2026-05-01"><day>01</day><month>05</month><year>2026</year></date><date date-type="accepted" iso-8601-date="2026-07-06"><day>06</day><month>07</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Consilium Medicum</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, ООО "Консилиум Медикум"</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Consilium Medicum</copyright-holder><copyright-holder xml:lang="ru">ООО "Консилиум Медикум"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-sa/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://ter-arkhiv.ru/0040-3660/article/view/707086">https://ter-arkhiv.ru/0040-3660/article/view/707086</self-uri><abstract xml:lang="en"><p>Exosomes are extracellular membrane vesicles with a diameter of 30–150 nm secreted by various cell types into the extracellular environment and regulating many vital physiological processes, including signaling, immune activation, proliferation, differentiation, and apoptosis. Numerous studies conducted in recent years have demonstrated the key role of exosomes in the development of various gastrointestinal diseases, including cancer, allowing them to be considered as potentially promising diagnostic biomarkers. Furthermore, due to their inherent biocompatibility, ability to overcome biological barriers, low toxicity, and immunogenicity, exosomes can be used for targeted drug delivery in the treatment of patients with gastrointestinal diseases. This review article systematizes and presents information on exosomes, their functions, extraction and detection methods, and examines the main exosomal markers, which demonstrate significant potential for the diagnosis and treatment of various gastrointestinal diseases.</p></abstract><trans-abstract xml:lang="ru"><p>Экзосомы представляют собой внеклеточные мембранные везикулы диаметром 30–150 нм, секретируемые различными типами клеток во внеклеточную среду и регулирующие многие жизненно важные физиологические процессы, включая передачу сигналов, активацию иммунной системы, пролиферацию, дифференцировку и апоптоз клеток. Результаты многочисленных исследований, проведенных в последние годы, свидетельствуют о ключевой роли экзосом в формировании различных заболеваний пищеварительного тракта, в том числе онкопатологии, что позволяет рассматривать их в качестве потенциально перспективных диагностических биомаркеров. Помимо этого благодаря биосовместимости, способности преодолевать биологические барьеры, низкой токсичности и иммуногенности экзосомы могут быть использованы для таргетной доставки лекарственных препаратов в терапии больных гастроэнтерологического профиля. В обзорной статье систематизированы и представлены сведения об экзосомах, их функции, методах экстракции и обнаружения, а также рассмотрены основные экзосомальные маркеры, демонстрирующие существенный потенциал для диагностики и лечения различных заболеваний органов пищеварения.</p></trans-abstract><kwd-group xml:lang="en"><kwd>exosomes</kwd><kwd>microRNA</kwd><kwd>reflux esophagitis</kwd><kwd>chronic gastritis</kwd><kwd>dyspepsia</kwd><kwd>autoimmune hepatitis</kwd><kwd>liver fibrosis</kwd><kwd>chronic pancreatitis</kwd><kwd>inflammatory bowel disease</kwd><kwd>oncological diseases of the digestive tract</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>экзосомы</kwd><kwd>микроРНК</kwd><kwd>рефлюкс-эзофагит</kwd><kwd>хронический гастрит</kwd><kwd>диспепсия</kwd><kwd>аутоиммунный гепатит</kwd><kwd>фиброз печени</kwd><kwd>хронический панкреатит</kwd><kwd>воспалительные заболевания кишечника</kwd><kwd>онкологические заболевания пищеварительного тракта</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI:10.1136/bmj.n71</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Zhang Y, Yue NN, Chen LY, et al. Exosomal biomarkers: A novel frontier in the diagnosis of gastrointestinal cancers. World J Gastrointest Oncol. 2025;17(4):103591. DOI:10.4251/wjgo.v17.i4.103591</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Johnstone RM, Adam M, Hammond JR, et al. Vesicle formation during reticulocyte maturation. Association of plasma membrane activities with released vesicles (exosomes). J Biol Chem. 1987;262(19):9412-20.</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Wellington VNA, Singh S. Role of exosomes in gastrointestinal physiology and pathophysiology. Front Immunol. 2026;16:1717977. DOI:10.3389/fimmu.2025.1717977</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Krylova SV, Feng D. The Machinery of Exosomes: Biogenesis, Release, and Uptake. Int J Mol Sci. 2023;24(2):1337. DOI:10.3390/ijms24021337</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Yu Z, Swift KA, Hedges MA, et al. Microscopic messengers: Extracellular vesicles shaping gastrointestinal health and disease. Physiol Rep. 2025;13(7):e70292. DOI:10.14814/phy2.70292</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Sonbhadra S, Mehak, Pandey LM. Biogenesis, Isolation, and Detection of Exosomes and Their Potential in Therapeutics and Diagnostics. Biosensors (Basel). 2023;13(8):802. DOI:10.3390/bios13080802</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Uemura R, Murakami Y, Hashimoto A, et al. Expression of Serum Exosomal and Esophageal MicroRNA in Rat Reflux Esophagitis. Int J Mol Sci. 2017;18(8):1611. DOI:10.3390/ijms18081611</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Xu R, Jiang Z, Meng X, et al. Cellular communication network 1 promotes CASP2 mRNA expression but suppresses its protein translation in esophageal adenocarcinoma. J Cell Commun Signal. 2024;18(3):e12046. DOI:10.1002/ccs3.12046</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>de Melo Viana TC, Nakamura ET, Park A, et al. Molecular Abnormalities and Carcinogenesis in Barrett's Esophagus: Implications for Cancer Treatment and Prevention. Genes (Basel). 2025;16(3):270. DOI:10.3390/genes16030270</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Tanaka F, Sawada A, Nishida Y, et al. Exosomal hsa-miR-3649 and hsa-miR-202-3p in Gastric Juice as Potential Biomarkers for Functional Dyspepsia with a Previous Helicobacter pylori Infection. Intern Med. 2026;65(8):1090-7. DOI:10.2169/internalmedicine.6047-25</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Tanaka F, Takashima S, Nadatani Y, et al. Exosomal hsa-miR-933 in Gastric Juice as a Potential Biomarker for Functional Dyspepsia. Dig Dis Sci. 2020;65(12):3493-501. DOI:10.1007/s10620-020-06096-7</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Wang J, Wang X, Luo H, et al. Extracellular vesicles in Helicobacter pylori-mediated diseases: mechanisms and therapeutic potential. Cell Commun Signal. 2025;23(1):79. DOI:10.1186/s12964-025-02074-6</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Alva V, Jain P, Khan K, et al. Helicobacter pylori associated MicroRNA and transcriptional networks in gastric pathogenesis: Exploring the epigenetic dialogue landscape. Microb Pathog. 2025;207:107864. DOI:10.1016/j.micpath.2025.107864</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>Sariani OK, Mohamadi M, Gharagheizi Z, et al. MicroRNA-Mediated Regulatory Networks in Helicobacter pylori-Associated Gastric Cancer. Biochem Res Int. 2025;2025:6662299. DOI:10.1155/bri/6662299</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>Gao Z, Fu K, Li P, et al. The role of microRNAs in gastritis, intestinal metaplasia, and gastric cancer: a narrative review. Transl Cancer Res. 2025;14(12):9063-81. DOI:10.21037/tcr-2025-1-2642</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>Liu N, Huang Y, Liu F, Liu H. Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG. Open Med (Wars). 2021;16(1):1350-5. DOI:10.1515/med-2021-0342</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Zingone F, Pilotto V, Cardin R, et al. Autoimmune Atrophic Gastritis: The Role of miRNA in Relation to Helicobacter Pylori Infection. Front Immunol. 2022;13:930989. DOI:10.3389/fimmu.2022.930989</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>Czaja AJ. Epigenetic Aspects and Prospects in Autoimmune Hepatitis. Front Immunol. 2022;3:921765. DOI:10.3389/fimmu.2022.921765</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>Ma L, Weng W, Chen J, et al. Bone marrow mesenchymal stem cell-derived exosomes attenuate hepatic stellate cell activation through miR-223-3p-mediated mitophagy. BMC Med Genomics. 2025;18:148. DOI:10.1186/s12920-025-02228-y</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>Wang C, Liu J, Yan Y, Tan Y. Role of Exosomes in Chronic Liver Disease Development and Their Potential Clinical Applications. J Immunol Res. 2022;2022:1695802. DOI:10.1155/2022/1695802</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>Киселева Я.В., Жариков Ю.О., Масленников Р.В., и др. Молекулярные факторы, ассоциированные с регрессом фиброза печени алкогольной этиологии. Терапевтический архив. 2021;93(2):204-20 [Kiseleva YaV, Zharikov YuO, Maslennikov RV, et al. Molecular factors associated with regression of liver fibrosis of alcoholic etiology. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(2):204-8 (in Russian)]. DOI:10.26442/00403660.2021.02.200617</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>Patel HR, Diaz Almanzar VM, LaComb JF, et al. The Role of MicroRNAs in Pancreatitis Development and Progression. Int J Mol Sci. 2023;24(2):1057. DOI:10.3390/ijms24021057</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>Cao J, Luo R, Miao R, et al. Engineered exosome nanovesicles for delivery of antibodies to treat inflammatory bowel disease. Nat Commun. 2026;17(1):2737. DOI:10.1038/s41467-026-69382-4</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Yarani R, Shojaeian A, Palasca O, et al. Differentially Expressed miRNAs in Ulcerative Colitis and Crohn’s Disease. Front Immunol. 2022;13:865777. DOI:10.3389/fimmu.2022.865777</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Sokal-Dembowska A, Jarmakiewicz-Czaja S, Helma K, Filip R. The Role of microRNAs in Inflammatory Bowel Disease. Int J Mol Sci. 2025;26(10):4750. DOI:10.3390/ijms26104750</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Wei QY, Jin F, Wang ZY, et al. MicroRNAs: A novel signature in the metastasis of esophageal squamous cell carcinoma. World J Gastroenterol. 21;30(11):1497-523. DOI:10.3748/wjg.v30.i11.1497</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Cataldi-Stagetti E, Governatori G, Orsini A, et al. MicroRNAs in Esophageal Cancer: Implications for Diagnosis, Progression, Prognosis and Chemoresistance. Int J Mol Sci. 2026;27(2):878. DOI:10.3390/ijms27020878</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Si MY, Rao DY, Xia Y, et al. Role of exosomal noncoding RNA in esophageal carcinoma. Front Oncol. 2023;13:1126890. DOI:10.3389/fonc.2023.1126890</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Bray F, Laversanne M, Sung H, et al. Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA A Cancer J Clin. 2024;74:229-63. DOI:10.3322/caac.21834</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>Yu J, Ostowari A, Gonda A, et al. Exosomes as a Source of Biomarkers for Gastrointestinal Cancers. Cancers (Basel). 2023;15(4):1263. DOI:10.3390/cancers15041263</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Kahroba H, Samadi N, Mostafazadeh M, et al. Evaluating the presence of deregulated tumoral onco-microRNAs in serum-derived exosomes of gastric cancer patients as noninvasive diagnostic biomarkers. Bioimpacts. 2022;12(2):127-38. DOI:10.34172/bi.2021.22178</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Kang F, Jiang F, Ouyang L, et al. Potential Biological Roles of Exosomal Long Non-Coding RNAs in Gastrointestinal Cancer. Front Cell Dev Biol. 2022;10:886191. DOI:10.3389/fcell.2022.886191</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Wei Y, Hu X, Yuan S, et al. Identification of plasma exosomal lncRNA as a biomarker for early diagnosis of gastric cancer. Front Genet. 2024;15:1425591. DOI:10.3389/fgene.2024.1425591</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Sarkar S, Bishoyi AK, Roopashree R, et al. Exosomes in Hepatocellular Carcinoma: A Comprehensive Review of Current Research and Future Directions. J Cell Mol Med. 2025;29(14):e70723. DOI:10.1111/jcmm.70723</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Eldosoky MA, Hammad R, Elmadbouly AA, et al. Diagnostic Significance of hsa-miR-21-5p, hsa-miR-192-5p, hsa-miR-155-5p, hsa-miR-199a-5p Panel and Ratios in Hepatocellular Carcinoma on Top of Liver Cirrhosis in HCV-Infected Patients. Int J Mol Sci. 2023;24(4):3157. DOI:10.3390/ijms24043157</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Tonon F, Grassi C, Tierno D, et al. Non-Coding RNAs as Potential Diagnostic/Prognostic Markers for Hepatocellular Carcinoma. Int J Mol Sci. 2024;25(22):12235. DOI:10.3390/ijms252212235</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Sun J, Awad MA, Hwang J, Villano AM. Molecular Biomarkers for the Diagnosis and Prognostication of Pancreatic Ductal Adenocarcinoma. J Pers Med. 2025;15(6):236. DOI:10.3390/jpm15060236</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>He X, Chen L, Di Y, et al. Plasma-derived exosomal long noncoding RNAs of pancreatic cancer patients as novel blood-based biomarkers of disease. BMC Cancer. 2024;24(1):961. DOI:10.1186/s12885-024-12755-z</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>Melo SA, Luecke LB, Kahlert C, et al. Author Correction: Glypican-1 identifies cancer exosomes and detects early pancreatic cancer. Nature. 2022;610(7932):E15-7. DOI:10.1038/s41586-022-05062-9</mixed-citation></ref><ref id="B41"><label>41.</label><mixed-citation>Bakhsh T, Alhazmi S, Farsi A, et al. Molecular detection of exosomal miRNAs of blood serum for prognosis of colorectal cancer. Sci Rep. 2024;14(1):8902. DOI:10.1038/s41598-024-58536-3</mixed-citation></ref><ref id="B42"><label>42.</label><mixed-citation>Jafari A, Karimabadi K, Rahimi A, et al. The Emerging Role of Exosomal miRNAs as Biomarkers for Early Cancer Detection: A Comprehensive Literature Review. Technol Cancer Res Treat. 2023;22:15330338231205999. DOI:10.1177/15330338231205999</mixed-citation></ref><ref id="B43"><label>43.</label><mixed-citation>Shi Y, Zhuang Y, Zhang J, et al. Four circulating exosomal miRNAs as novel potential biomarkers for the early diagnosis of human colorectal cancer. Tissue Cell. 2021;70:101499. DOI:10.1016/j.tice.2021.101499</mixed-citation></ref></ref-list></back></article>
