Extracellular vesicles (EVs) have emerged as pivotal players in cancer therapy, particularly in drug delivery and biomarker discovery. Recent studies have demonstrated the potential of engineered exosomes to enhance therapeutic efficacy. For instance, Li et al. reported that miR146a-loaded exosomes, when combined with a silk fibroin patch, significantly promoted diabetic wound healing by targeting IRAK1, showcasing the versatility of exosomes in therapeutic applications (ref: Li doi.org/10.1038/s41392-022-01263-w/). Furthermore, Han et al. identified a prognostic EV mRNA signature consisting of PPP1R12A, SCN7A, and SGCD for non-invasive risk stratification of pancreatic ductal adenocarcinoma (PDAC) patients, highlighting the role of EVs in patient survival prediction (ref: Han doi.org/10.1186/s13045-023-01404-w/). Morimoto et al. explored the role of MUC1-C as a master regulator of MICA/B NKG2D ligand and exosome secretion in cancer cells, linking chronic inflammation to oncogenesis and suggesting a mechanism by which EVs can modulate immune responses (ref: Morimoto doi.org/10.1136/jitc-2022-006238/). Additionally, Chen et al. demonstrated that exosomal circTUBGCP4 promotes colorectal cancer metastasis by activating the Akt signaling pathway, further emphasizing the importance of EVs in cancer progression (ref: Chen doi.org/10.1186/s13046-023-02619-y/). The potential of exosomes as drug delivery vehicles was also underscored by Raguraman and Ducrot, who reviewed the advantages of exosomes in targeted drug delivery and their unique properties compared to traditional vectors (ref: Raguraman doi.org/10.1016/j.canlet.2023.216093/; Ducrot doi.org/10.1016/j.canlet.2023.216107/). Overall, the integration of EVs in cancer therapy presents a promising frontier, with ongoing research focusing on their multifaceted roles in drug delivery, biomarker discovery, and therapeutic modulation.

The role of extracellular vesicles (EVs) in wound healing and tissue regeneration has gained significant attention, particularly in the context of enhancing regenerative processes. Suh et al. demonstrated that mitochondrial-derived vesicles (MDVs) secreted from mature osteoblasts promote osteogenesis and enhance bone regeneration in vivo, indicating that mitochondrial morphology is adapted for extracellular secretion and plays a critical role in bone healing (ref: Suh doi.org/10.1016/j.cmet.2023.01.003/). Jin et al. further explored the regenerative potential of exosomes derived from young stem cells, showing that these exosomes restore aging-impaired tendon stem/progenitor cell function, thereby enhancing their reparative capacity (ref: Jin doi.org/10.1002/adma.202211602/). Xiong et al. introduced a whole-course-repair system utilizing a hydrogel to promote neurogenesis and angiogenesis in diabetic wound healing, highlighting the importance of a favorable immune microenvironment for effective tissue repair (ref: Xiong doi.org/10.1002/adma.202212300/). The integration of these findings underscores the therapeutic potential of EVs in regenerative medicine, as they not only facilitate cellular communication but also enhance the intrinsic healing processes of tissues.

Extracellular vesicles (EVs) play a crucial role in metabolic regulation, particularly in the context of obesity and insulin resistance. Kulaj et al. found that adipocyte-derived extracellular vesicles (AdEVs) from obese mice significantly increased insulin secretion and improved glucose tolerance, suggesting that the protein cargo of AdEVs is altered in obesity and contributes to metabolic dysfunction (ref: Kulaj doi.org/10.1038/s41467-023-36148-1/). In a different context, Qu et al. highlighted the role of cancer-associated fibroblast-derived exosomal DACT3-AS1 in promoting malignant transformation and chemoresistance in gastric cancer, indicating that metabolic pathways are intricately linked to cancer progression and treatment resistance (ref: Qu doi.org/10.1016/j.drup.2023.100936/). This interplay between EVs, metabolism, and disease underscores the potential of targeting EV-mediated communication pathways for therapeutic interventions in metabolic disorders and cancer. Furthermore, Pottel et al. introduced a cystatin C-based equation for estimating glomerular filtration rate (GFR) without race and sex inclusion, emphasizing the need for accurate metabolic assessments in clinical settings (ref: Pottel doi.org/10.1056/NEJMoa2203769/). Collectively, these studies illustrate the multifaceted roles of EVs in metabolic regulation and their potential as therapeutic targets.

Extracellular vesicles (EVs) are increasingly recognized for their roles in neuroinflammation and neurodegeneration, particularly in mediating intercellular communication in the brain. He et al. reported that astrocyte-derived exosomal lncRNA 4933431K23Rik modulates microglial activation and improves recovery following traumatic brain injury, suggesting that EVs can influence neuroinflammatory responses and promote neuroprotection (ref: He doi.org/10.1016/j.ymthe.2023.01.031/). Antoniou et al. further elucidated the role of neuronal EVs in enhancing synaptic connectivity through the delivery of specific microRNAs, demonstrating that brain-derived neurotrophic factor (BDNF) mediates the sorting of these miRNAs, which are critical for excitatory synapse formation (ref: Antoniou doi.org/10.1016/j.celrep.2023.112063/). Additionally, Gnörich et al. investigated the impact of microglial activity on metabolic connectivity in the mouse brain, revealing that microglial states significantly influence brain metabolism and connectivity, which are crucial in neurodegenerative diseases (ref: Gnörich doi.org/10.1186/s12974-023-02735-8/). These findings collectively highlight the complex roles of EVs in neuroinflammation and neurodegeneration, suggesting that targeting EV-mediated pathways could offer novel therapeutic strategies for neurodegenerative disorders.

Extracellular vesicles (EVs) are increasingly implicated in cardiovascular diseases, serving as both biomarkers and potential therapeutic targets. Ludwig et al. identified TGFβ-carrying exosomes in plasma as potential biomarkers for cancer progression in head and neck squamous cell carcinoma, indicating that EVs can reflect systemic changes associated with disease progression (ref: Ludwig doi.org/10.1038/s41416-023-02184-3/). Goikoetxea-Usandizaga et al. explored the role of mitochondrial activity in alcohol-associated liver disease, revealing that targeting methylation-controlled J protein (MCJ) could recover mitochondrial fitness and mitigate oxidative damage, which is crucial for cardiovascular health (ref: Goikoetxea-Usandizaga doi.org/10.1097/HEP.0000000000000303/). Furthermore, Tu et al. developed engineered metallacycle-based supramolecular photosensitizers for photodynamic therapy, demonstrating their potential in treating cardiovascular conditions through enhanced therapeutic efficacy (ref: Tu doi.org/10.1002/anie.202301560/). These studies underscore the multifaceted roles of EVs in cardiovascular diseases, highlighting their potential as biomarkers and therapeutic agents.

Extracellular vesicles (EVs) are gaining recognition for their roles in infectious diseases, particularly in mediating host-pathogen interactions. Zhao et al. demonstrated that EVs from Zika virus-infected cells display viral E protein, which binds ZIKV-neutralizing antibodies, thereby preventing infection enhancement. This finding underscores the potential of EVs in modulating immune responses during viral infections (ref: Zhao doi.org/10.15252/embj.2022112096/). Baker et al. investigated the reciprocal modulation of ammonia and melanin production in Cryptococcus neoformans, revealing that these factors contribute to the pathogen's virulence and may serve as targets for therapeutic intervention (ref: Baker doi.org/10.1038/s41467-023-36552-7/). Additionally, Feng et al. utilized atomic force microscopy to uncover the nanomechanical signatures of EVs from hematologic cancer patients, suggesting that these signatures could enhance the understanding of liquid biopsies in infectious disease contexts (ref: Feng doi.org/10.1021/acs.nanolett.3c00093/). Collectively, these studies highlight the diverse roles of EVs in infectious diseases, emphasizing their potential as biomarkers and therapeutic targets.

Extracellular vesicles (EVs) are emerging as critical players in diabetes and metabolic disorders, influencing cellular communication and metabolic regulation. Paul et al. applied a parallelized multidimensional analytic framework to mammary epithelial cells, uncovering regulatory principles in epithelial to mesenchymal transition (EMT) that could have implications for understanding metabolic disorders (ref: Paul doi.org/10.1038/s41467-023-36122-x/). This study highlights the complexity of metabolic signaling pathways and their potential interactions with EVs. Furthermore, the role of EVs in mediating insulin signaling and glucose metabolism is underscored by the findings of Kulaj et al., who demonstrated that adipocyte-derived EVs from obese mice enhance insulin secretion and glucose tolerance, suggesting a significant link between EVs and metabolic health (ref: Kulaj doi.org/10.1038/s41467-023-36148-1/). These insights into the roles of EVs in diabetes and metabolic disorders underscore their potential as therapeutic targets and biomarkers for disease management.

Extracellular vesicles (EVs) are increasingly recognized for their potential in biomarker discovery, particularly in cancer diagnostics. Su et al. developed an integrated SERS-vertical flow biosensor that enables multiplexed quantitative profiling of serological exosomal proteins, facilitating accurate breast cancer subtyping (ref: Su doi.org/10.1021/acsnano.3c00449/). This innovative approach highlights the utility of EVs in non-invasive cancer diagnostics and personalized treatment strategies. Additionally, Li et al. constructed a microfluidic chip for the detection of exosome SORL1, demonstrating its application in the early diagnosis of colorectal cancer, further emphasizing the role of EVs as promising biomarkers (ref: Li doi.org/10.1002/smll.202207381/). Bracht et al. investigated the impact of platelet removal from plasma on the detection of extracellular vesicle-associated miRNA, revealing that the presence of platelets can lead to overestimation of miRNA concentrations, thus highlighting the importance of sample preparation in biomarker studies (ref: Bracht doi.org/10.1002/jev2.12302/). Collectively, these studies underscore the transformative potential of EVs in biomarker discovery and their implications for clinical diagnostics.