Extracellular Vesicles and Exosomes as Biomarkers in Huntington's Disease: Uncovering Pathogenic Insights and Pioneering Therapies.

Huntington's disease (HD) is a neurodegenerative disorder caused by the expression of the mutant huntingtin protein (mHTT), characterized by a progressive decline in motor function, cognitive abilities, and psychiatric symptoms. Exosomes, a distinct class of small extracellular vesicles, have emerged as promising diagnostic biomarkers and potential therapeutic tools for early disease detection and intervention. This is largely attributed to their molecular stability, cell type-specific cargo, and potential to cross the blood-brain barrier under optimized structural or delivery conditions. Extracellular vesicles (EVs) exhibit disease-associated molecular modifications and can either exacerbate or alleviate proteotoxic stress in Huntington's disease. This review provides a comprehensive overview of the role of exosomes in HD, covering their biogenesis, functional characteristics, diagnostic potential, and therapeutic applications in neural degeneration associated with HD.