Cytokine and growth factor secretion by PBMCs stimulated with EVs. PBMCs were cultured unstimulated or stimulated with day 0, 21, and 42 EVs. Supernatants were collected at 24 hours and were tested using a multiplex cytokine assay for 39 cytokines and growth factors. Data are representative of PBMC culture supernatants from 3 healthy donors and 3 unstimulated and 6 EV-stimulated replicates for days 0 and 21 and 5 replicates for day 42 (*P < .05, q < 0.1, EV stimulated vs unstimulated condition). (A) Results for stimulated conditions were normalized to unstimulated data and log₂ transformed to show log-fold increase after stimulation. (B) Cytokine secretion patterns associated with T-helper cell subsets. (C) Secretion pattern of IL-1β and IL-18. (D) Detailed presentation of T-cell growth factors. EGF, epidermal growth factor; FGF-2, fibroblast growth factor 2; Flt3L, FMS-related tyrosine kinase 3 ligand; Gro, growth regulated protein (CXCL3); MCP-1, monocyte chemoattractant protein 1 (CCL2); MCP-3, monocyte chemoattractant protein 3 (CCL7); MDC, macrophage-derived chemokine (CCL22); MIP-1α, macrophage inflammatory protein 1α (CCL3); MIP-1β, macrophage inflammatory protein 1β (CCL4); VEGF, vascular endothelial growth factor.