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Extracellular vesicles (EVs) from cardiac stromal cells, developed as therapeutic candidates, improve dystrophic muscle function when administered parenterally, but oral delivery remains untested. We find that casein, the dominant protein in breast milk, enhances the uptake and bioactivity of ingested heart‐derived EVs, altering gene expression in blood cells and enhancing muscle function in mdx mice with muscular dystrophy. Thus, EVs, administered orally, are absorbed and exert disease‐modifying bioactivity in vivo. Formulating EVs with casein enhances uptake and markedly expands the range of potential therapeutic applications. [ABSTRACT FROM AUTHOR]

Cardiosphere-derived cells ( CDCs) reduce myocardial infarct size via secreted extracellular vesicles ( CDC-EVs), including exosomes, which alter macrophage polarization. We questioned whether short non-coding RNA species of unknown function within CDC-EVs contribute to cardioprotection. The most abundant RNA species in CDC-EVs is a Y RNA fragment (EV- YF1); its relative abundance in CDC-EVs correlates with CDC potency in vivo. Fluorescently labeled EV- YF1 is actively transferred from CDCs to target macrophages via CDC-EVs. Direct transfection of macrophages with EV- YF1 induced transcription and secretion of IL-10. When cocultured with rat cardiomyocytes, EV- YF1-primed macrophages were potently cytoprotective toward oxidatively stressed cardiomyocytes through induction of IL-10. In vivo, intracoronary injection of EV- YF1 following ischemia/reperfusion reduced infarct size. A fragment of Y RNA, highly enriched in CDC-EVs, alters Il10 gene expression and enhances IL-10 protein secretion. The demonstration that EV- YF1 confers cardioprotection highlights the potential importance of diverse exosomal contents of unknown function, above and beyond the usual suspects (e.g., micro RNAs and proteins). [ABSTRACT FROM AUTHOR]