{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:06:12Z","timestamp":1790784372577,"version":"4.1.0"},"reference-count":157,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministry of Economy, Industry and Competitiveness","doi-asserted-by":"publisher","award":["SAF2016-77096-R"],"award-info":[{"award-number":["SAF2016-77096-R"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003339","name":"Spanish National Research Council","doi-asserted-by":"publisher","award":["2020AEP018"],"award-info":[{"award-number":["2020AEP018"]}],"id":[{"id":"10.13039\/501100003339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Most patients with ovarian cancer (OvCA) present peritoneal disseminated disease at the time of diagnosis. During peritoneal metastasis, cancer cells detach from the primary tumor and disseminate through the intraperitoneal fluid. The peritoneal mesothelial cell (PMC) monolayer that lines the abdominal cavity is the first barrier encountered by OvCA cells. Subsequent progression of tumors through the peritoneum leads to the accumulation into the peritoneal stroma of a sizeable population of carcinoma-associated fibroblasts (CAFs), which is mainly originated from a mesothelial-to-mesenchymal transition (MMT) process. A common characteristic of OvCA patients is the intraperitoneal accumulation of ascitic fluid, which is composed of cytokines, chemokines, growth factors, miRNAs, and proteins contained in exosomes, as well as tumor and mesothelial suspended cells, among other components that vary in proportion between patients. Exosomes are small extracellular vesicles that have been shown to mediate peritoneal metastasis by educating a pre-metastatic niche, promoting the accumulation of CAFs via MMT, and inducing tumor growth and chemoresistance. This review summarizes and discusses the pivotal role of exosomes and MMT as mediators of OvCA peritoneal colonization and as emerging diagnostic and therapeutic targets.<\/jats:p>","DOI":"10.3390\/ijms222111496","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T21:40:21Z","timestamp":1635198021000},"page":"11496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Mesothelial-to-Mesenchymal Transition and Exosomes in Peritoneal Metastasis of Ovarian Cancer"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7270-1629","authenticated-orcid":false,"given":"Luc\u00eda","family":"Pascual-Ant\u00f3n","sequence":"first","affiliation":[{"name":"Tissue and Organ Homeostasis Program, Cell-Cell Communication and Inflammation Unit, Centro de Biolog\u00eda Molecular \u201cSevero Ochoa\u201d (UAM-CSIC), Consejo Superior de Investigaciones Cient\u00edficas, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Carde\u00f1es","sequence":"additional","affiliation":[{"name":"Tissue and Organ Homeostasis Program, Cell-Cell Communication and Inflammation Unit, Centro de Biolog\u00eda Molecular \u201cSevero Ochoa\u201d (UAM-CSIC), Consejo Superior de Investigaciones Cient\u00edficas, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Sainz de la Cuesta","sequence":"additional","affiliation":[{"name":"Department of Gynecoloy and Obstretics, Hospital Universitario Quir\u00f3nsalud, 28223 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Gonz\u00e1lez-Cortijo","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hospital Universitario Quir\u00f3nsalud, 28223 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0976-9719","authenticated-orcid":false,"given":"Manuel","family":"L\u00f3pez-Cabrera","sequence":"additional","affiliation":[{"name":"Tissue and Organ Homeostasis Program, Cell-Cell Communication and Inflammation Unit, Centro de Biolog\u00eda Molecular \u201cSevero Ochoa\u201d (UAM-CSIC), Consejo Superior de Investigaciones Cient\u00edficas, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8767-060X","authenticated-orcid":false,"given":"Carlos","family":"Caba\u00f1as","sequence":"additional","affiliation":[{"name":"Tissue and Organ Homeostasis Program, Cell-Cell Communication and Inflammation Unit, Centro de Biolog\u00eda Molecular \u201cSevero Ochoa\u201d (UAM-CSIC), Consejo Superior de Investigaciones Cient\u00edficas, 28049 Madrid, Spain"},{"name":"Department of Immunology, Ophthalmology and Otorhinolaryngology, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Lymphocyte Immunobiology Group, Inflammatory and Immune Disorders Area, Instituto de Investigaci\u00f3n Sanitaria Hospital 12 de Octubre (i+12), 28041 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Tissue and Organ Homeostasis Program, Cell-Cell Communication and Inflammation Unit, Centro de Biolog\u00eda Molecular \u201cSevero Ochoa\u201d (UAM-CSIC), Consejo Superior de Investigaciones Cient\u00edficas, 28049 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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