Biogenesis and function of extracellular vesicles in pathophysiological processes of skeletal muscle atrophy

Pathophysiological changes of skeletal muscle occur in a variety of chronic diseases, leading to muscle atrophy and dysfunction, which greatly affect the quality of life. Despite decades of research, the pathogenesis of muscle atrophy remains poorly understood. Extracellular vesicles (EVs) have recently been demonstrated to be associated with the pathophysiological process of skeletal muscle. EVs are membrane-encapsulated nanovesicles secreted by multiple organisms. They can deliver bioactive molecules (proteins, lipids, DNA and RNA, etc.) to the target cells, affecting the biological function of the target cells. The delivery of bioactive molecules by EVs has become an important mode of intercellular communication. In this review, we discuss the biogenesis, classification, extraction and identification of EVs, clarify the role of bioactive molecules in EVs in skeletal muscle growth, regeneration and atrophy and explore the potential of EVs as a novel biomarker and therapeutic carrier for skeletal muscle diseases. The current review aims to highlight the emerging evidence linking EVs to the pathophysiological mechanism of skeletal muscle atrophy and to discuss the perspectives of EVs as a treatment for skeletal muscle atrophy.