Targeted delivery of extracellular vesicles: the mechanisms, techniques and therapeutic applications

作者：Shuang Zhao, Yunfeng Di, Huilan Fan, Cheng‐Yan Xu, Haijing Li, Yong Wang, Wei Wang, Chun Li, Jingyu Wang · 发表于：Molecular Biomedicine · 年份：2024 · DOI：10.1186/s43556-024-00230-x · 被引用次数：77 · 研究领域：Extracellular vesicles in disease、Phagocytosis and Immune Regulation、RNA Interference and Gene Delivery

Extracellular vesicles (EVs) are cell-derived vesicles with a phospholipid bilayer measuring 50-150 nm in diameter with demonstrated therapeutic potentials. Limitations such as the natural biodistribution (mainly concentrated in the liver and spleen) and short plasma half-life of EVs present significant challenges to their clinical translation. In recent years, growing research indicated that engineered EVs with enhanced targeting to lesion sites have markedly promoted therapeutic efficacy. However, there is a dearth of systematic knowledge on the recent advances in engineering EVs for targeted delivery. Herein, we provide an overview of the targeting mechanisms, engineering techniques, and clinical translations of natural and engineered EVs in therapeutic applications. Enrichment of EVs at lesion sites may be achieved through the recognition of tissue markers, pathological changes, and the circumvention of mononuclear phagocyte system (MPS). Alternatively, external stimuli, including magnetic fields and ultrasound, may also be employed. EV engineering techniques that fulfill targeting functions includes genetic engineering, membrane fusion, chemical modification and physical modification. A comparative statistical analysis was conducted to elucidate the discrepancies between the diverse techniques on size, morphology, stability, targeting and therapeutic efficacy in vitro and in vivo. Additionally, a summary of the registered clinical trials utilizing EVs from 2010 to 2023 h...