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Depending on their biogenesis, there is a complex repertoire of EVs that differ in size and origin. EVs can carry lipids, proteins, coding and non-coding RNAs, and mitochondrial DNA causing alterations to the recipient cells, functioning as intercellular mediators of cell\u2013cell communication (auto-, para-, juxta-, or even endocrine). Nevertheless, many questions remain unanswered in relation to the function of EVs under physiological and pathological conditions. The development and optimization of methods for EV isolation are crucial for characterizing their biological functions, as well as their potential as a treatment option in the clinic. In this manuscript, we will comprehensively review the results from different studies that investigated the role of hepatic EVs during liver diseases, including non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, alcoholic liver disease, fibrosis, and hepatocellular carcinoma. In general, the identification of patients with early-stage liver disease leads to better therapeutic interventions and optimal management. Although more light needs to be shed on the mechanisms of EVs, their use for early diagnosis, follow-up, and prognosis has come into the focus of research as a high-potential source of \u2018liquid biopsies\u2019, since they can be found in almost all biological fluids. The use of EVs as new targets or nanovectors in drug delivery systems for liver disease therapy is also summarized.<\/jats:p>","DOI":"10.3390\/ijms232416217","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T07:59:21Z","timestamp":1671436761000},"page":"16217","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Extracellular Vesicles as Biomarkers in Liver Disease"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3765-6276","authenticated-orcid":false,"given":"Roc\u00edo","family":"Mu\u00f1oz-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0853-4800","authenticated-orcid":false,"given":"\u00c1ngela","family":"Rojas","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Gato","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Gallego","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9622-1761","authenticated-orcid":false,"given":"Antonio","family":"Gil-G\u00f3mez","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5221-0032","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Castro","sequence":"additional","affiliation":[{"name":"Servicio de Citometr\u00eda y Separaci\u00f3n Celular, Instituto de Biomedicina de Sevilla Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Ampuero","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"UCM Digestive Diseases, Virgen del Roc\u00edo University Hospital, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8494-8947","authenticated-orcid":false,"given":"Manuel","family":"Romero-G\u00f3mez","sequence":"additional","affiliation":[{"name":"SeLiver Group, Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital\/CSIC\/University of Seville, 41013 Seville, Spain"},{"name":"CIBERehd, Instituto de Salud Carlos III, 28029 Madrid, Spain"},{"name":"UCM Digestive Diseases, Virgen del Roc\u00edo University Hospital, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jhep.2018.09.014","article-title":"Burden of liver diseases in the world","volume":"70","author":"Asrani","year":"2019","journal-title":"J. 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