Arthur Aquino, Artem Rubinstein, I. V. Kudryavtsev, А. А. Yakovlev, А. С. Головкин
Extracellular vesicles (EVs) are membrane-bound nanoparticles naturally secreted by cells, playing a vital role in intercellular communication and holding significant promise as therapeutic agents. These natural carriers deliver various molecules into cells, including proteins and nucleic acids. There are numerous methods to load and modify EVs, encompassing physical, chemical, and biological approaches. EVs demonstrate the capacity to target specific cells within organs, even requiring blood–tissue transition. The protein corona significantly influences EV availability and cargo delivery, with biomolecules residing both within and conjugated to the EV membrane. Furthermore, embedding EVs within biomaterials such as hydrogels, scaffolds, and nanofibers can enhance their stability, targeting specificity, and therapeutic potential. By addressing cargo loading and cell/tissue-specific targeting, EVs offer a novel therapeutic strategy for various diseases, including cancer, autoimmune disorders, and neurodegenerative diseases. Furthermore, EVs show promise as vaccination tools, delivering messenger RNA and proteins of various pathogens. Advances in EV biology and engineering would provide improved strategies for vesicle targeting, enhanced cargo loading, and safe and effective delivery. The convergence of technological advancements, interdisciplinary collaboration, and an enhanced understanding of EVs promises to revolutionize therapeutic approaches to a wide range of diseases, establishing EV-based treatments as a cornerstone of future medicine.