Roghaieh Holghoomi, Abbas Rahdar, Jamileh Kadkhoda, Vahideh Mohammadzadeh, Maryam Shirzad, Bahardokht Salehi, Mohammad-Sadra Ebrahimi, Sadanand Pandey
Cell-derived vesicles or exosomes, as biomimetic systems, have significant potential to overcome the challenges associated with conventional drug delivery methods due to their inherent biocompatibility, precise targeting capabilities of extracellular vesicles and low immunogenicity, and are emerging as promising drug carriers for targeted drug delivery in neurodegenerative diseases. Exosomes ensure local drug delivery to the affected areas of the central nervous system by effectively crossing the highly selective and dynamic blood–brain barrier. In addition, significant advances in exosome engineering techniques have enabled the customization of vesicle properties such as surface modifications and cargo loading to enhance therapeutic efficacy. In this review, exosomes and their applications in drug delivery systems are introduced, and various strategies for engineering exosomes to improve cargo delivery, as well as their use in neurodegenerative disorders, are reviewed, along with challenges and future prospects.