Fig. 2

Pharmacological mechanisms and properties of TDSEVs. Components of TDSEVs participate in intercellular communication and management of tumor microenvironment. TDSEVs contain a plethora of proteins and enzymes engaged in metabolic processes. ILVs are primarily characterized by abnormal production of several different oncoproteins, including caveolin-1, HB-EGF, and MyrAkt1 TDSEVs orchestrate tumorigenic cascade via regulating early metastasis processes, pre-metastatic niche formation carrying telomerase and MMIF, immune system regulation, angiogenesis initiation, ECM remodeling, EMT pathway. TGF-β is transferred by TDSEVs from cancerous cells to healthy fibroblasts, increasing the development of myofibroblasts. DNA within TDSEVs exhibit major translational significance by regulating circulating biomarkers aiding in the early identification of cancer and metastasis. SEV miRs, can in turn lead to a pro-metastatic inflammatory response involving cytokines TNF-α and interleukins. Interestingly, TRAIL, from TDSEVs can restore apoptosis at tumor sites. ‘↑’ represents upregulation. Arrows indicate downstream cellular events/activation