Inhibiting the synthesis or secretion of exosomes prevents the aggregation of tau protein in the brain.336–338 Inhibition of exosome biosynthesis by blocking the activity of a key enzyme regulating ceramide biosynthesis, neutral sphingomyelinase 2, reduced the proliferation of Aβ plaque and tau in AD mouse model.339 Some enzymes carried in exosomes, such as neprilysin and insulin-degrading enzymes, reduce intracellular and extracellular Aβ levels.340 In summary, exosomes participate in the pathogenesis of AD by transmitting different substances or information. This evidence concerns the gene INS and Alzheimer disease.