Resistance to cisplatin has been also associated to increased expression of annexin A3 by ovarian cancer cells
and this molecule could be found in culture medium of the same cells. Electronmicroscopy studies showed that high expression of annexin A3 was linked to increased amount of vesicles in the cytoplasm and these were also detectable as exosomes in culture medium, illustrating another evidence for exosome-mediated countering of cisplatin action [104]. Potential effects on tumor exosome production were also evaluated in radiation-treated cancer cells. Prostate cancer patients are often treated using radiation therapy that, according to the authors, induces premature cellular senescence accounting for most of the clonogenic death in prostate cancer cells [105]. In this context the same group assessed that treatment-induced senescent cells secrete increased amounts of EPZ-6438 exosome-like vesicles and that this phenomenon was dependent on activation of p53, whose involvement in the regulation of exosome release was
previously shown [106]. Exosome-like vesicles may thus comprise an important and previously unrecognized feature of premature cellular senescence [107]. In contrast, Khan et al. showed that irradiation of tumor cells led to changes in exosome composition rather than in the secretion rate. Treatment of cervical carcinoma cells with sublethal doses of irradiation resulted in increased survivin content in exosomes. Since extracellular survivin was able to enhance cellular proliferation, survival and tumor SCH 900776 Tryptophan synthase cell invasion, one could hypothesize a role for survivin-carrying exosomes in sustaining the recovery from stress-induced injury, as in the case
of irradiation [14]. A participation of tumor exosomes has been also described in countering antibody-mediated cancer therapies, in particular for Trastuzumab in breast cancer treatment. In this regard, HER2-expressing exosomes isolated from sera of breast cancer patients bound to this antibody and autologous exosomes inhibited Trastuzumab activity on SKBR3 proliferation [11]. By binding of tumor-reactive antibodies, breast cancer exosomes were also shown to reduce antibody-dependent cytotoxicity (ADCC) of immune effector cells, one of the fundamental anti-tumor reactions of the immune system [108]. Similarly, in an in vitro model of aggressive B cell lymphoma, CD20-expressing tumor exosomes were able to consume complement and shield target cells from antibody attack, resulting in protection from complement-dependent cytolysis (CDC) as well as ADCC [109]. As vesicular structures released into the extracellular space, tumor exosomes are receiving increasing attention for their role in intercellular communication.