Extracellular vesicles (EVs) have emerged as critical mediators in various disease mechanisms, particularly in inflammatory and infectious diseases. A study demonstrated that engineered extracellular vesicles derived from dermal fibroblasts significantly attenuated inflammation in a murine model of acute lung injury, highlighting their potential therapeutic role in conditions like acute respiratory distress syndrome (ARDS) (ref: Salazar-Puerta doi.org/10.1002/adma.202210579/). Furthermore, the use of apoptotic vesicles has been shown to ameliorate autoimmune conditions such as lupus and arthritis through phosphatidylserine-mediated modulation of T cell receptor signaling, suggesting a novel immunomodulatory approach (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). Additionally, the study on exosome-guided reprogramming of tumor-associated macrophages indicates that EVs can be utilized to shift the immune landscape from protumorigenic to antitumorigenic, further emphasizing their role in disease modulation (ref: Kim doi.org/10.1016/j.bioactmat.2022.07.021/). These findings collectively underscore the multifaceted roles of EVs in disease mechanisms, offering insights into potential therapeutic applications across various conditions.

In cancer research, extracellular vesicles are increasingly recognized for their role in tumor progression and treatment resistance. A pivotal study revealed that cancer-associated fibroblasts suppress ferroptosis and induce gemcitabine resistance in pancreatic cancer cells by secreting exosome-derived miRNAs targeting ACSL4, thus highlighting the intricate interplay between tumor microenvironment and drug resistance (ref: Qi doi.org/10.1016/j.drup.2023.100960/). Moreover, the engineering of EVs from human mesenchymal stromal cells (hMSCs) in a vertical-wheel bioreactor has been shown to enhance their secretion and cargo profile, which is crucial for developing effective cancer therapies (ref: Jeske doi.org/10.1016/j.bioactmat.2022.07.004/). The potential of apoptotic vesicles to modulate immune responses in cancer further supports their therapeutic promise, as they can influence T cell activity and promote immune tolerance (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). Collectively, these studies illustrate the dual role of EVs in both promoting tumorigenesis and serving as therapeutic agents, emphasizing the need for further exploration of their mechanisms.

Extracellular vesicles are gaining attention in the context of neurological disorders, particularly for their potential in therapeutic delivery and neuroprotection. Research has shown that exosomal lipid PI4P plays a crucial role in regulating small extracellular vesicle secretion by modulating intraluminal vesicle formation, thereby influencing the biogenesis of EVs in neuronal contexts (ref: Jin doi.org/10.1002/jev2.12319/). Additionally, the application of autologous exosomes loaded with bioactive peptides has demonstrated promise in spinal cord injury models, facilitating targeted delivery and enhancing repair processes (ref: Ran doi.org/10.1016/j.bioactmat.2022.07.002/). The ability of engineered EVs to reprogram immune cells in the tumor microenvironment also suggests a potential strategy for addressing neuroinflammation associated with various neurological disorders (ref: Kim doi.org/10.1016/j.bioactmat.2022.07.021/). These findings highlight the versatility of EVs as therapeutic tools in neurology, warranting further investigation into their mechanisms and applications.

In immunology, extracellular vesicles are pivotal in mediating intercellular communication and modulating immune responses. The exosome-guided reprogramming of tumor-associated macrophages from a protumorigenic to an antitumorigenic state illustrates the potential of EVs in reshaping immune landscapes within tumors (ref: Kim doi.org/10.1016/j.bioactmat.2022.07.021/). Furthermore, apoptotic vesicles derived from mesenchymal stem cells have been shown to influence T cell receptor signaling, promoting immune tolerance and potentially ameliorating autoimmune conditions (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). The enhancement of EV secretion and cargo profiles through bioreactor systems also suggests that engineered EVs could be harnessed for therapeutic purposes in immunological disorders (ref: Jeske doi.org/10.1016/j.bioactmat.2022.07.004/). These studies collectively underscore the multifaceted roles of EVs in immune regulation and their potential as therapeutic agents in various immunological contexts.

Extracellular vesicles are being explored as innovative therapeutic agents in cardiovascular research, particularly for their role in myocardial infarction treatment. A study demonstrated that endothelial progenitor cells, when stimulated with silicate ions, produce highly bioactive extracellular vesicles that can significantly aid in myocardial repair following ischemic injury (ref: Yu doi.org/10.1038/s41467-023-37832-y/). This approach highlights the potential of biomaterial-based strategies to enhance EV production and functionality for clinical applications. Additionally, the engineering of hMSC-derived EVs in dynamic bioreactor cultures has been shown to improve their therapeutic cargo, which is crucial for effective cardiovascular interventions (ref: Jeske doi.org/10.1016/j.bioactmat.2022.07.004/). The modulation of immune responses through apoptotic vesicles also suggests a potential avenue for addressing inflammation associated with cardiovascular diseases (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). These findings indicate the promising role of EVs in cardiovascular therapy, warranting further exploration of their mechanisms and applications.

In the realm of metabolic disorders, extracellular vesicles are being investigated for their role in intercellular communication and potential therapeutic applications. The ability of EVs to influence immune responses and metabolic pathways is underscored by studies demonstrating their role in reprogramming tumor-associated macrophages, which can have implications for metabolic regulation in the tumor microenvironment (ref: Kim doi.org/10.1016/j.bioactmat.2022.07.021/). Furthermore, the use of autologous exosomes loaded with bioactive peptides has shown promise in enhancing repair mechanisms in spinal cord injury, which may also relate to metabolic recovery processes (ref: Ran doi.org/10.1016/j.bioactmat.2022.07.002/). The upscaling of hMSC-derived EV production in bioreactor systems further emphasizes the potential for developing EV-based therapies targeting metabolic disorders (ref: Jeske doi.org/10.1016/j.bioactmat.2022.07.004/). These insights highlight the multifaceted roles of EVs in metabolic regulation and their potential as therapeutic agents.

Extracellular vesicles are increasingly recognized for their potential in regenerative medicine, particularly in tissue repair and regeneration. The engineering of EVs from endothelial progenitor cells has shown that silicate ions can enhance the production of bioactive extracellular vesicles, which may significantly contribute to myocardial repair following ischemic injury (ref: Yu doi.org/10.1038/s41467-023-37832-y/). Additionally, autologous exosomes loaded with bioactive peptides have demonstrated efficacy in spinal cord injury models, facilitating targeted delivery and promoting neural repair (ref: Ran doi.org/10.1016/j.bioactmat.2022.07.002/). The modulation of immune responses through apoptotic vesicles also suggests a potential strategy for enhancing regenerative outcomes in various tissues (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). Collectively, these findings underscore the promising role of EVs in regenerative medicine, highlighting their potential to improve therapeutic strategies for tissue repair.

Extracellular vesicles are emerging as valuable biomarkers in diagnostics, particularly for their potential to reflect disease states and therapeutic responses. The ability of EVs to carry specific molecular signatures from their parent cells makes them ideal candidates for non-invasive diagnostic tools. Studies have shown that engineered EVs can be utilized to reprogram immune cells, which may have implications for diagnostic applications in cancer and other diseases (ref: Kim doi.org/10.1016/j.bioactmat.2022.07.021/). Furthermore, the enhancement of EV production and cargo profiles through bioreactor systems suggests that these vesicles can be optimized for diagnostic purposes (ref: Jeske doi.org/10.1016/j.bioactmat.2022.07.004/). The immunomodulatory potential of apoptotic vesicles also indicates their relevance in understanding disease mechanisms and developing diagnostic markers (ref: Wang doi.org/10.1016/j.bioactmat.2022.07.026/). These insights highlight the promising role of EVs in diagnostics, paving the way for innovative approaches to disease detection and monitoring.