Monocyte-derived exosomal periostin driven by histone lactylation contributes to retinal neovascularization

W Wei Shen Z Zheng Nie (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) M Mengzhu Wang (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) H Haorui Zhang (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) Y Yongxuan Liu (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) H Huimin Zhu (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) W Wen Zhou L Lin Zhang M Min Zhao H Hao Zeng (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) M Mai Peng (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) Y Yukun Zhou (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) J Jiawei Zhao (State Key Laboratory of Physical Chemistry of Solid Surfaces, iChEM, College of Chemistry and Chemical Engineering, Innovation Laboratory for Sciences and Technologies of Energy Materials of Fujian Province (IKKEM), Xiamen University, Xiamen 361005, China) S Shikun Wang (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University) G Guangping Gao Y Yuxin Jiang (Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine) W Wenbin Zou (Department of Gastroenterology, Shanghai Institute of Pancreatic Diseases, Shanghai Changhai Hospital, Naval Medical University) X Xi Shen (Beijing National Laboratory for Condensed Matter Physics, Institute of Physics) L Liqiang Wang (Department of Mechanical Engineering) H Hongyuan Song (Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University)

Abstract

Exosomes are signaling messengers facilitating intercellular communication by delivering molecular cargo. Here, we observed increased levels of exosomal periostin (POSTN) in the blood plasma of patients with proliferative diabetic retinopathy (PDR). Monocytes contributed to elevated levels of exosomal POSTN, and deletion of Postn in myeloid cells reduced retinal neovascularization (RNV). Monocytes isolated from the blood of PDR patients or under high glucose conditions exhibited heightened glycolytic activity and elevated histone lactylation levels, particularly H4K8 lactylation (H4K8la). Knockout of hexokinase 2 ( Hk2 ) in myeloid cells led to reduced H4K8la and POSTN levels and inhibited RNV. Exogenous exosomal POSTN partially reversed the angiogenic defects caused by Postn or Hk2 deletion in myeloid cells. Mechanistically, exosomal POSTN stabilized hypoxia-inducible factor -1 alpha and upregulated the expression of angiogenic genes. Notably, treatment with metformin reduced RNV by decreasing monocyte glycolysis and lowering exosomal POSTN levels. In summary, these findings underscore the critical role of circulating exosomal POSTN in RNV and highlight its potential as a therapeutic target for angiogenic retinopathies.

Article Details

Volume / Issue Vol. 122, Issue 44
Published November 04, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (20)

W

Wei Shen

Z

Zheng Nie

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

M

Mengzhu Wang

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

H

Haorui Zhang

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

Y

Yongxuan Liu

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

H

Huimin Zhu

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

W

Wen Zhou

L

Lin Zhang

M

Min Zhao

H

Hao Zeng

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

M

Mai Peng

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

Y

Yukun Zhou

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

J

Jiawei Zhao

State Key Laboratory of Physical Chemistry of Solid Surfaces, iChEM, College of Chemistry and Chemical Engineering, Innovation Laboratory for Sciences and Technologies of Energy Materials of Fujian Province (IKKEM), Xiamen University, Xiamen 361005, China

S

Shikun Wang

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University

G

Guangping Gao

Y

Yuxin Jiang

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

W

Wenbin Zou

Department of Gastroenterology, Shanghai Institute of Pancreatic Diseases, Shanghai Changhai Hospital, Naval Medical University

X

Xi Shen

Beijing National Laboratory for Condensed Matter Physics, Institute of Physics

L

Liqiang Wang

Department of Mechanical Engineering

H

Hongyuan Song

Department of Ophthalmology, Shanghai Changhai Hospital, Naval Medical University