Extracellular vesicles (EVs) have emerged as critical players in cancer biology, serving as vehicles for intercellular communication and potential biomarkers for diagnosis and therapy. Recent studies have highlighted the diagnostic potential of plasma EVs in neurodegenerative diseases, particularly in frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS). For instance, one study analyzed EV tau and TDP-43 levels in a cohort of 704 patients, revealing that EV tau ratios were significantly altered in different disease states, with high levels in FTD with tau pathology and elevated TDP-43 in ALS (ref: Chatterjee doi.org/10.1038/s41591-024-02937-4/). Another investigation focused on engineered EVs designed to reprogram cancer-associated fibroblasts (CAFs) in pancreatic cancer, demonstrating that these engineered vesicles could effectively modulate the tumor microenvironment, thereby enhancing therapeutic efficacy (ref: Zhou doi.org/10.1038/s41392-024-01872-7/). Additionally, the role of exosomal circSIPA1L3 in glucose metabolic reprogramming in triple-negative breast cancer was explored, indicating its potential as a diagnostic marker due to its high expression in patient serum (ref: Liang doi.org/10.1186/s12943-024-02037-4/). These findings collectively underscore the multifaceted roles of EVs in cancer progression and their potential as biomarkers and therapeutic targets.

The role of extracellular vesicles in neurodegenerative diseases has gained significant attention, particularly in the context of FTD and ALS. A study assessing molecular pathology markers in blood EVs found that the detectability of various biomarkers was enhanced using advanced techniques, revealing significant correlations between EV content and disease states (ref: Unknown doi.org/10.1038/s41591-024-02985-w/). Furthermore, the analysis of plasma EV tau and TDP-43 levels in a large cohort demonstrated that these markers could differentiate between various neurodegenerative conditions, with specific ratios indicating the presence of tau pathology in FTD and TDP-43 pathology in ALS (ref: Chatterjee doi.org/10.1038/s41591-024-02937-4/). Another study linked LRRK2 kinase activity in serum to inflammation in Parkinson's disease, suggesting that the extracellular ratio of phosphorylated Rab10 could serve as a pharmacodynamic biomarker for disease severity (ref: Yuan doi.org/10.1186/s13024-024-00738-4/). These studies illustrate the potential of EVs as diagnostic tools and therapeutic targets in neurodegenerative diseases.

Extracellular vesicles are increasingly recognized for their roles in cardiovascular health and disease. Research has shown that aortic valve stenosis can lead to systemic endothelial dysfunction, with studies indicating that EVs may mediate these effects by carrying bioactive molecules that influence endothelial function (ref: Quast doi.org/10.1161/CIRCULATIONAHA.123.064747/). Additionally, engineered EVs derived from cardiac cells have demonstrated antifibrotic properties, suggesting their potential as a therapeutic strategy for cardiac fibrosis, a common complication in cardiovascular diseases (ref: Prieto-Vila doi.org/10.1002/jev2.12461/). The impact of environmental toxins, such as benzo[a]pyrene, on EV-mediated communication in hepatocellular carcinoma has also been explored, revealing that these vesicles can activate fibroblasts and promote metastasis, highlighting the complex interplay between cancer and cardiovascular health (ref: Mu doi.org/10.1002/cac2.12574/). Collectively, these findings emphasize the importance of EVs in cardiovascular research and their potential as therapeutic targets.

The engineering of extracellular vesicles for therapeutic applications is a rapidly evolving field, with significant advancements in targeted drug delivery systems. One study highlighted the use of membrane fusion-mediated loading techniques to enhance the delivery of therapeutic siRNA into exosomes, aiming for tissue-specific applications beyond the liver (ref: Xie doi.org/10.1002/adma.202403935/). Another investigation focused on biointerface-engineered hybrid nanovesicles designed to reprogram the tumor microenvironment, particularly in triple-negative breast cancer, demonstrating improved drug-loading efficiency and stability (ref: Zhen doi.org/10.1002/adma.202401495/). Additionally, engineered EVs have shown promise in modulating CAFs in pancreatic cancer, suggesting a novel approach to enhance therapeutic outcomes (ref: Zhou doi.org/10.1038/s41392-024-01872-7/). These studies underscore the potential of engineered EVs in targeted therapies and their role in overcoming challenges associated with conventional treatment modalities.

Extracellular vesicles play a crucial role in mediating immune responses and inflammation, with recent studies shedding light on their complex interactions within the immune system. One study demonstrated that the extracellular ratio of phosphorylated Rab10 is linked to inflammation in Parkinson's disease, suggesting that EVs can serve as biomarkers for disease severity and immune activation (ref: Yuan doi.org/10.1186/s13024-024-00738-4/). Furthermore, the investigation of non-coding RNAs in EVs revealed that yREX3 can exert cardioprotective effects through macrophage-mediated mechanisms, highlighting the immunomodulatory potential of EVs in cardiovascular contexts (ref: Ciullo doi.org/10.1093/eurheartj/). Additionally, the exposure to environmental toxins like benzo[a]pyrene has been shown to activate lung fibroblasts via HCC-derived exosomal circular RNAs, indicating a pathway for cancer-stroma communication that may influence inflammatory responses (ref: Mu doi.org/10.1002/cac2.12574/). These findings illustrate the multifaceted roles of EVs in regulating immune responses and their potential as therapeutic targets in inflammatory diseases.

The involvement of extracellular vesicles in metabolic disorders is an emerging area of research, with studies exploring their roles in disease progression and potential therapeutic applications. One study highlighted the impact of benzo[a]pyrene on HCC-derived exosomes, which were found to activate lung fibroblasts and promote metastasis, suggesting a link between environmental toxins and metabolic dysregulation (ref: Mu doi.org/10.1002/cac2.12574/). Additionally, the role of BAG6 in pancreatic cancer progression was investigated, revealing that it restricts the release of IL33-presenting EVs, thereby influencing mast cell activation and tumor growth (ref: Alashkar Alhamwe doi.org/10.1038/s41423-024-01195-1/). These findings indicate that EVs may serve as both biomarkers and therapeutic targets in metabolic disorders, highlighting their potential in understanding disease mechanisms and developing novel treatment strategies.

Extracellular vesicles are increasingly recognized as valuable sources for biomarker discovery across various diseases. In neurodegenerative diseases, studies have demonstrated the potential of blood EVs to serve as diagnostic markers for FTD and ALS, with specific tau and TDP-43 levels correlating with disease severity and pathology (ref: Chatterjee doi.org/10.1038/s41591-024-02937-4/). Furthermore, advanced detection methods have improved the sensitivity of identifying these biomarkers, enhancing their clinical applicability (ref: Unknown doi.org/10.1038/s41591-024-02985-w/). In the context of inflammation, the extracellular ratio of phosphorylated Rab10 has been proposed as a novel pharmacodynamic biomarker for LRRK2-linked immune activation in Parkinson's disease, linking EV content to disease severity (ref: Yuan doi.org/10.1186/s13024-024-00738-4/). These studies highlight the potential of EVs in biomarker discovery, paving the way for non-invasive diagnostic tools and personalized medicine approaches.