Fig. 4

Outline of the alterations in each component regulated by sEV proteins in the PCa TME. In addition to exerting pro-tumorigenic effects at the primary site of PCa, sEVs proteins also play a role in creating conditions for metastasis at distant sites. A sEV proteins promote the differentiation of fibroblasts into cancer-associated fibroblasts (CAFs) and remodel the extracellular matrix (ECM). B sEV proteins promote epithelial-mesenchymal transition (EMT) in PCa cells. C sEV proteins facilitate abnormal angiogenesis, providing nutrients for tumor growth. D sEV proteins promote the transformation of macrophages into the M2 phenotype, recruit pro-tumorigenic regulatory T cells (Tregs), induce CD8⁺ T cell apoptosis, and inhibit natural killer (NK) cell cytotoxicity, thus facilitating immune evasion. E sEV proteins enhance PCa cell proliferation. F sEV proteins promote the activation of inflammasomes, leading to the occurrence of inflammation in the tumor microenvironment (TME). G sEV proteins act on distant sites to establish pre-metastatic niches (PMNs)