An indispensable tool: Exosomes play a role in therapy for radiation damage

Radiotherapy is one of the three main treatments for tumors. Almost 70% of tumor patients undergo radiotherapy at different periods. Although radiotherapy can enhance the local control rate of tumors and patients’ quality of life, normal tissues often show radiation damage following radiotherapy. In recent years, several studies have shown that exosomes could be biomarkers for diseases and be involved in the treatment of radiation damage. Exosomes are nanoscale vesicles containing complex miRNAs and proteins. They can regulate the inflammatory response, enhance the regeneration effect of damaged tissue, and promote the repair of damaged tissues and cells, extending their survival time. In addition, their functions are achieved by paracrine signaling. In this review, we discuss the potential of exosomes as biomarkers and introduce the impact of exosomes on radiation damage in different organs and the hematopoietic system in detail. [Display omitted] •Exosomes have therapeutic effects on radiation injury of lung, skin, intestine, testicle, bone and blood systems.•Exosomes treat radiation-induced lung injury by regulating the immune microenvironment, alleviating pulmonary fibrosis and promoting tissue regeneration and repair.•Exosomes can be used not only as markers of disease and prognosis, but also as early markers of radiation injury.