MiRNA-enriched exosomes derived from TNF-treated fibroblasts not only inhibited the Nrf2/ARE signaling pathway, but also promoted the expression of cardiac hypertrophy-related genes, implying that these exosomes can inhibit Nrf2 translation and subsequent transcription of downstream targeting genes that contribute to cardiac hypertrophy 51. The gene discussed is TNF; the disease is cardiac hypertrophy.