Interoception, heart failure and exosomal cargo as potential biomarkers

Interoception, the intricate process that helps an organism to sense, interpret, integrate, and regulate neural and non-neural signals from within itself, governs the internal state of that organism. This is a fundamental physiological mechanism which ensures the maintenance of homeostasis, thus profoundly impacting the physical and mental well-being of the individual. In addition to well-established neurobiological signaling pathways, the body also utilizes a diverse set of mechanisms to facilitate intimate organ-to-organ communication, as exemplified by the synthesis and secretion of extracellular exosomes, the micro-vesicles that are essentially made by almost all the cells. This review article explores the intricate interplay between interoceptive impairment, the exosomal contents and their relevance to specific health conditions, with a particular emphasis on cardiovascular diseases. It elucidates potential novel avenues for the diagnosis and treatment of the conditions by harnessing the therapeutic and diagnostic potentials inherent in the exosomal cargo, encompassing cell- or tissue-specific bioactive molecules such as lipids, proteins, and miRNAs. Furthermore, the distinct molecular signatures associated with pathophysiological states not only contribute to disease progression but also hold promise as potential biomarkers for targeted therapeutic interventions. Within the context of cardiovascular diseases, the heart is subjected to myocardial stress resulting from volume or pressure overload, ultimately culminating in heart failure. This pathological condition triggers multifaceted responses, encompassing immune system activation and hormonal secretion, to compensate for cardiac damage. Despite the established association between exosomal secretion by organs, the specific molecules within exosomes responsible for cardiac function remain elusive. In this work, we conduct an analysis of two hormones, namely erythropoietin (produced by the kidney) and musclin (secreted by skeletal muscle), unveiling their crucial roles in inter-organ communication for cardiac function. This work also provides insights into the complex interplay between interoception, exosomal role, and cardiovascular health, while highlighting novel diagnostic approaches and targeted therapeutic applications for managing the heart failure phenotype.