Tinghong Kuang, Lijun Wang, Yaning Shi, Ji Cheng, Shifeng Pan
Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most prevalent chronic liver diseases worldwide, involving multiple pathological mechanisms such as lipid metabolism disorders, oxidative stress, chronic inflammation, insulin resistance, and dysregulation of the gut-liver axis. Currently, there remains a lack of effective and long-term safe therapeutic strategies for MASLD, necessitating the development of novel interventions. Plant-derived exosome-like nanovesicles (PELNs) represent naturally secreted nanoscale vesicles derived from plant cells. Their advantages, including extensive availability, high biocompatibility, low immune activation, remarkable stability, and convenient oral administration, make them attractive platforms for therapeutic delivery. PELNs can not only encapsulate natural bioactive compounds such as polyphenols, alkaloids, terpenoids, and polysaccharides but also serve as drug delivery vehicles to achieve liver-targeted transport and synergistic therapy. Current evidence for PELNs in MASLD is predominantly preclinical. In vitro studies have provided mechanistic insights into their effects on lipid metabolism, oxidative stress, inflammatory signaling, and hepatocellular injury, whereas animal studies have demonstrated improvements in hepatic steatosis and related metabolic abnormalities for selected PELNs. A smaller number of studies have investigated tissue distribution, oral uptake, or preliminary biosafety. However, systematic pharmacokinetic, long-term toxicological, and target-species clinical evidence remains insufficient. Accordingly, the therapeutic effects discussed in this review should be interpreted primarily as preclinical findings, and the applicability of PELNs in veterinary practice remains to be established.