Glioblastoma‐derived extracellular vesicle subpopulations following 5‐aminolevulinic acid treatment bear diagnostic implications

Liquid biopsy is a minimally invasive alternative to surgical biopsy, encompassing different analytes including extracellular vesicles (EVs), circulating tumour cells (CTCs), circulating tumour DNA (ctDNA), proteins, and metabolites. EVs are released by virtually all cells, but at a higher rate by faster cycling, malignant cells. They encapsulate cargo native to the originating cell and can thus provide a window into the tumour landscape. EVs are often analysed in bulk which hinders the analysis of rare, tumour‐specific EV subpopulations from the large host EV background. Here, we fractionated EV subpopulations in vitro and in vivo and characterized their phenotype and generic cargo. We used 5‐aminolevulinic acid (5‐ALA) to induce release of endogenously fluorescent tumour‐specific EVs (EV(PpIX)). Analysis of five different subpopulations (EV(PpIX), EV(CD63), EV(CD9), EV(EGFR), EV(CFDA)) from glioblastoma (GBM) cell lines revealed unique transcriptome profiles, with the EV(PpIX) transcriptome demonstrating closer alignment to tumorigenic processes over the other subpopulations. Similarly, isolation of tumour‐specific EVs from GBM patient plasma showed enrichment in GBM‐associated genes, when compared to bulk EVs from plasma. We propose that fractionation of EV populations facilitates detection and isolation of tumour‐specific EVs for disease monitoring.