Plasmatic Extracellular Vesicles at the Intersection of Immune and Metabolic Dysregulation in Obesity and Type 2 Diabetes

Abstract

Background and Aims: Type 2 diabetes (T2D), often driven by obesity and chronic inflammation, remains a major health challenge. Regulatory T cells (Tregs, CD4⁺CD25^high) are key to immune tolerance, and their dysfunction may contribute to T2D pathogenesis. We hypothesize that plasmatic extracellular vehicles (EVs) reflect metabolic dysregulation and impair Treg function, thus promoting inflammation and increasing T2D susceptibility.

Materials/Patients and Methods: We recruited lean (BMI 25) individuals with normal glucose tolerance, impaired glucose tolerance, or T2D. EVs were isolated from plasma via size-exclusion chromatography and characterized for concentration, size, and molecular cargo (proteins and microRNAs). Circulating Tregs were analyzed by flow cytometry for phenotype and proliferation. Functional in vitro assays are ongoing to assess the effects of EVs on Treg activation and suppressive function.