The future of Extracellular Vesicles as Theranostics – an ISEV meeting report

Figures & data

Table 1. Summary of topics, descriptions and questions for 4 roundtable discussions.

Roundtable #1
Topic	EV Isolation Methods and Standardization
Descriptions	Methodologies that are used for EV isolation from different sample sources were discussed. The focus was on isolation methods suitable for EVs that are intended to be utilized for theranostics applications and pre-analytical issues which may affect EV isolation and analysis.
Questions	1. What are the main problems in EV isolation? 2. Are there isolation methods that are most suitable for clinical theranostics? 3. How can we standardize the pre-analytical sample quality?
Roundtable #2
Topic	EV Omics Analysis and Biomarker Discovery
Descriptions	Omics analyses, including RNA sequencing, proteomics, lipidomics, and metabolomics, are common platforms used for biomarker screening. The focus here was on questions to be addressed when performing omics studies for EV biomarker discovery.
Questions	1. How can we achieve most stringent quality control? Is there a recommendation on platform(s) that we can use to share omics datasets? 2. How can we avoid false discovery or inaccurate detection during the discovery phase of EV-based protein biomarkers? 3. Regarding RNA sequence data analysis: Should we reach a consensus on an algorithm which is suitable for RNA-seq? What are recommendations for normalization of omics datasets? 4. Do we need to treat EVs with RNase before sequencing to confirm the RNA cargo content? Do we need to treat EVs with protease enzymes before performing proteomics analysis for protein cargo content? 5. What volume of samples is needed for the RNA library construction? 6. How many samples should be included for initial biomarker discovery? How can we improve the confidence for data verification? 7. How could omics datasets be translated to clinical applications? 8. After lipidomic analysis, what assays and platforms can be used for lipid verification?
Roundtable #3
Topic	EV Biomarker Detection and Applications in Clinical Diagnostics
Descriptions	EV biomarker detection technologies are instrumental in applications on clinical diagnostics. Here, the potential of using EV-related biomarkers, such as EV number and/or cargo, as diagnostics was discussed. Also, some novel techniques were considered as potential tools for EV-based clinical diagnostics.
Questions	1. What kind of EV-based biomarkers are suitable for clinical diagnosis? 2. Are there any new technologies that can be used for biomarker detection to help meet clinical requirements and standardization? 3. What are the main challenges for biomarker detection and applications?
Roundtable #4
Topic	EV-based Therapies in Human Disease
Descriptions	EVs have been proposed as new therapeutic or delivery agents. Here, the potentials and challenges for EV-based therapies for diseases, including immunomodulatory and regenerative therapies, vaccinations and drug delivery were considered.
Questions	1. What are the main challenges in the development of EV-based therapies? 2. What are the requirements for manufacturing, quality control and subsequent clinical use?