Exosomes carry and transmit signaling molecules used for intercellular communication. The generation and secretion of exosomes is a multistep interlocking process that allows simultaneous control of multiple regulatory sites. Protein molecules

mainly RAB GTPases

cytoskeletal proteins and soluble N-ethylmaleimide-sensitive fusion attachment protein receptor (SNARE)

are specifically regulated in response to pathological conditions such as altered cellular microenvironment

stimulation by pathogenic factors

or gene mutation. This interferes with the smooth functioning of endocytosis

translocation

degradation

docking and fusion processes

leading to changes in the secretion of exosomes. Large numbers of secreted exosomes are disseminated by the flow of body fluids and absorbed by the recipient cells. By transmitting characteristic functional proteins and genetic information produced under disease conditions

exosomes can change the physiological state of the recipient cells and their microenvironment. The microenvironment

in turn

affects the occurrence and development of disease. Therefore

this review will discuss the mechanism by which exosome secretion is regulated in cells following the formation of mature secretory multivesicular bodies (MVBs). The overall aim is to find ways to eliminate disease-derived exosomes at their source

thereby providing an important new basis for the clinical treatment of disease.