TY - GEN AU - Cook-Calvete,A. AU - Delgado-Marin,M. AU - Fernandez-Rodriguez,B. AU - Zaragoza,C. AU - Saura,M. KW - calcific aortic valve disease KW - cardiovascular calcification KW - drug delivery KW - extracellular vesicles KW - microRNAs KW - predictive biomarkers KW - therapeutic targets KW - valve remodeling T1 - Extracellular Vesicles in Calcific Aortic Valve Disease: From Biomarkers to Drug Delivery Applications LA - eng PY - 2025/11/01/ T2 - Biomolecules SN - 2218-273X VL - 15 IS - 11 PB - Multidisciplinary Digital Publishing Institute (MDPI) AB - Calcific aortic valve disease (CAVD) is a progressive disorder where molecular alterations occur long before visible calcification, making early biomarkers essential. Extracellular vesicles (EVs) have gained attention as stable biomarkers due to their lipid bilayer, which protects proteins, lipids, and RNAs, ensuring reliable detection even in archived samples. This review highlights the role of EVs as biomarkers and delivery tools in CAVD. EVs derived from valvular endothelial, interstitial, and immune cells carry disease-specific signatures, including osteogenic proteins (BMP-2, Annexins), inflammatory miRNAs (miR-30b, miR-122-5p), and lipid mediators. These reflect early pathogenic processes before macroscopic calcification develops. Their presence in minimally invasive samples such as blood, urine, or saliva facilitates diagnosis, while their stability supports long-term monitoring of disease progression and therapeutic response. Advances in purification and single-EV analysis increase specificity, though challenges remain in standardizing methods and distinguishing CAVD-derived EVs from those in atherosclerosis. Beyond diagnostics, engineered EVs show promise as therapeutic carriers. Delivery of anti-calcific miRNAs or combined RNA cargos has reduced calcification and inflammation in preclinical models. Overall, EVs act as molecular mirrors of CAVD, enabling early diagnosis, risk stratification, and novel therapeutic strategies. Yet, clinical translation requires technical refinement and validation of the disease-specific signatures. DO - 10.3390/BIOM15111548 UR - https://portalcientifico.uah.es/documentos/6934914d69f8cf470682da55 DP - Dialnet - Portal de la Investigación ER -