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Patients with stress-induced exhaustion disorder (SED) demonstrate cognitive dysfunction similar to patients with minor traumatic brain injury (TBI). We have previously detected elevated concentrations of astrocyte-derived extracellular vesicles (EVs) in patients with TBI. As such, we hypothesized that astrocyte-derived EVs could be higher in patients with SED than in patients with major depressive disorder (MDD) and healthy controls. Patients with SED (n = 31), MDD (n = 31), and healthy matched controls (n = 61) were included. Astrocyte-derived EVs (previously known as microparticles) were measured in plasma with flow cytometry and labeled against glial fibrillary acidic protein (GFAP) and aquaporin 4 (AQP4). In addition, platelet EVs and their CD40 ligand expression were measured. Patients with SED had significantly higher concentrations of AQP4 and GFAP-positive EVs and EVs co-expressing AQP4/GFAP than patients with MDD and healthy controls. Patients with MDD had significantly higher concentrations of GFAP-positive EVs and EVs co-expressing AQP4/GFAP than healthy controls. Platelet EVs did not differ between groups. CD40 ligand expression was significantly higher in patients with SED and MDD than in controls. In conclusion, the present study suggests that patients with SED, and to some extent, patients with MDD, have increased leakage of astrocyte-derived EVs through the blood-brain barrier.

Objective: With the development of exosomes studies increased around the whole world. Our present study was aimed to investigate the global status and trends in exosomes field., Methods: Publications related to exosomes studies from 1994 to 2017 were retrieved from the Web of Science database. The data source was studied and indexed by using bibliometric methodology. For visualized study, VOS viewer software was used to conduct bibliographic coupling analysis, coauthorship analysis, cocitation analysis, and cooccurrence analysis and to analyze the publication trend in exosomes research., Results: A total of 4960 publications were included. The relative research interests and number of publications were increasing per year globally. The USA made the highest contributions to the global research with the most citations, the highest H-index, and the most total link strength, while Sweden had the highest average citation per item. The journal PLOS ONE had the highest publication number. The Natl Canc Ctr was the most contributive institutions. Studies could be divided into three clusters: mechanism study, in vivo study, and in vitro study., Conclusions: The efforts should be put into mechanism studies, predicted to be the next hot spots in exosomes studies.