EV/EPs deliver DNA to the recipient cell cytosol. a Horizontal gene transfer. EV/EP DNA can translocate to the recipient cell nucleus or mitochondria, where it is integrated into the host genome. Subsequent transcription of this DNA heavily influences recipient cell function, and phenotypic changes depend on the genotype of cells from which the EV/EP DNA was derived. b Activation of oncogenic pathways. EV/EP DNA can activate or cause the up-regulation of various intracellular signalling proteins, such as STAT3, causing translocation to the nucleus and over-expression of oncogenes that drive a pro-tumourigenic phenotype in the recipient cell. c Activation of inflammatory pathways. EV/EP DNA can trigger various cytosolic DNA receptors, including AIM2 (which subsequently produces interleukins) and cGAS. Activation of cGAS causes downstream release of Type I Interferons that induce inflammatory responses unique to the disease context.