Fig. 4

Immune modulatory pathways through TDSEVs. TDSEVs exert detrimental effects on TcR and IL-2R activities. TDSEVs can reduce JAK expression and phosphorylation in activated T cells. TDSEVs can also boost CD4 + T cell expression while lowering CD8 + T cell proliferation. TDSEVs, once again, can increase STAT5 phosphorylation in activated CD4 + T cells while decreasing STAT5 phosphorylation in active CD8 + T cells. TDSEV-mediated apoptosis is characterized by DNA fragmentation, caspase-3 cleavage, mitochondrial cytochrome C release, and MMP loss. TDSEVs also impact the PI3K/Akt signaling pathway to increase apoptosis via Akt dephosphorylation. TDSEVs can also excite NK cells by activating NKG2D receptors on the surface of SEVs. Interestingly, cancer cell growth, invasion, and migration can be aided by M2 macrophage ‘↑’ indicates upregulation, ‘↓’ indicates downregulation. Arrows indicate downstream cellular events/activation. IL-2R. interleukin 2 receptor; MMP. Mitochondrial membrane potential TcR, T cell receptor