Clinical research using extracellular vesicles: insights from the International Society for Extracellular Vesicles 2018 Annual Meeting

Figures & data

Figure 1. Analysis workflow.

Figure 2. The number of clinical abstracts by category.

Figure 3. The number of clinical abstracts from various countries presented at the 2018 International Society for Extracellular Vesicles Annual Meeting.

Figure 4. The distribution of sample sizes for clinical abstracts which reported a sample size.

Table 1. Questions to be answered towards the clinical relevance of extracellular vesicle research.

Question		Current Status	Likely Future Directions
Can extracellular vesicle assays be made clinically usable?
	Which pre-analytical variables affect results?	Highly fragmented and incomplete knowledge; unpublished answers might be known to some groups; answers are likely to be context-dependent	ISEV Roadmaps for each commonly assayed body fluid
	ISO certification	At least one ISO-certified method of EV isolation exists	More certification of methods
	Automatability	Few, if any, automated EV isolation methods exist	Development of workflows with automated separation of extracellular vesicles and standardized interpretation of downstream assay results
	Scalability	EV isolation is labour-intensive, requiring major investment to scale up to large numbers of samples	Increased role for robotics in extracellular vesicle assays
Do assays for clinical use need to separate pure vesicles, or is an admixture of analytes acceptable?
	Repeatability versus purity	Simpler, more easily repeated methods are often more contaminated with non-extracellular vesicle material	Intensive investigation of the downstream analytical consequences of pure or less pure separation of vesicles
Do we need more transparent or more proprietary methods?
	Openness versus commercialization	Many commercially available methods of isolating extracellular vesicles do not indicate the exact principle of the assay.	Continued development of open methods concurrent with commercially destined proprietary processes