Aug 2026· Current Neurovascular Research· 0 citations
Medicine
TL;DR
The findings support the therapeutic potential of exosome-based platforms while also highlighting major challenges, including inconsistencies in isolation protocols, limited cargo- loading capacity, targeting specificity, and in vivo stability.
Abstract
Background
Glioma is one of the most aggressive and treatment-resistant malignancies of the central nervous system, characterized by rapid progression and poor prognosis. Conventional treatment approaches, including surgery, radiotherapy, and chemotherapy, often fail to achieve long-term remission due to the restrictive nature of the blood-brain barrier and the inherent heterogeneity of tumor cells.
Methods
This review summarizes and critically analyzes current preclinical and clinical evidence on exosome biology, including their biogenesis, molecular cargo, and therapeutic engineering strategies. It further highlights recent advances in exosome-based delivery of chemotherapeutic agents, microRNAs, and gene-editing systems for glioma management.
Results
Tumor- and stem cell-derived exosomes have demonstrated the ability to cross biological barriers while carrying functional biomolecules and modulating the tumor microenvironment. Their inherent stability, low immunogenicity, and capacity for surface modification make them promising nanocarriers for therapeutic applications. Engineered exosomes loaded with anti- tumor microRNAs, small interfering RNAs, or chemotherapeutic nanoparticles have shown promising results in enhancing drug sensitivity and reducing tumor proliferation in experimental glioma models.
Discussion
The findings support the therapeutic potential of exosome-based platforms while also highlighting major challenges, including inconsistencies in isolation protocols, limited cargo- loading capacity, targeting specificity, and in vivo stability. Although exosomes have demonstrated the ability to overcome biological barriers and therapeutic resistance, standardized manufacturing protocols and robust clinical validation remain essential for successful clinical translation.
Conclusion
Exosome-based systems represent a promising approach for the diagnosis and treatment of glioma. Their dual role as biomarkers and therapeutic drug carriers offers significant potential for personalized medicine through non-invasive disease monitoring and targeted therapeutic strategies. However, further optimization of large-scale production, purification methods, and clinical translation is necessary before exosome-based therapeutics can be integrated into standard glioma treatment protocols.
This review critically examines exosome sources, isolation and characterization methodologies, cargo-loading strategies, biodistribution, pharmacokinetics, and engineering approaches together with their applications in delivering small-molecule drugs and nucleic acid-based therapeutics to overcome multidrug resistance in cancer.
Yaseera Arif, D. N. Moholkar, Raghuram Kandimalla et al.· Journal of Controlled Releas...· 0 citations
Despite their promise, significant challenges remain, including low cargo-loading efficiency, batch heterogeneity, limited scalability and the absence of standardized manufacturing and regulatory frameworks, future research must address these barriers to accelerate the clinical translation of exosome-based therapeutics.
Elza Karabagh, Babek Alibayov, Adil Allahverdiyev· Expert Reviews in Molecular...· 0 citations
As core subsets of extracellular vesicles, exosomes mediate intercellular signal communication and carry diverse biomolecules that faithfully reflect the phenotypic characteristics of parent cells. In oncology research, exosomes exert two opposing biological effects on tumor progression and clinical intervention. This paper systematically sorts the dual regulatory functions of exosomes and summarizes their translational prospects for tumor liquid biopsy and targeted drug delivery. Tumor-derived exosomes remodel local and distant tumor microenvironments, suppress anti-tumor immune responses, facilitate angiogenesis and epithelial-mesenchymal transition, and transmit drug-resistant traits to sensitive tumor cells. Meanwhile, exosomes with intact lipid bilayer structures can protect internal nucleic acids and proteins from enzymatic degradation, serving as stable non-invasive biomarkers for early tumor screening and efficacy monitoring. Genetically modified engineered exosomes can load chemotherapeutics, small interfering RNAs and immune regulators to achieve tumor-specific targeted delivery. This paper systematically elaborates the molecular mechanisms, clinical diagnostic value, therapeutic potential and translational bottlenecks of exosomes in precision oncology. Current evidence proves exosome-based liquid biopsy supports early tumor detection, primary lesion tracing and dynamic efficacy evaluation. However, standardized separation protocols, unified quality control standards and long-term safety evaluation systems have not been fully established, restricting large-scale clinical transformation. Follow-up interdisciplinary research needs to form unified technical specifications to promote the clinical application of exosome-based diagnosis and treatment integrated strategies.
Yuanyuan Zhou· Theoretical and Natural Scie...· 0 citations
A translational framework for overcoming key barriers in pharmaceutical intervention design for oncology applications is outlined, integrating drug delivery engineering, molecular biopharmaceutics, and computational optimization.
Manoj Dalabehera, Shubham K. Chaudhari, Jatin Kumar et al.· Journal of Pharmacy and Scie...· 0 citations
Melanoma is one of the most lethal and aggressive forms of skin malignancies, which characterized by a high mutational burden, rapid metastatic dissemination and development of resistance to targeted and conventional therapies. Increasing interest in site-specific delivery has led to tailored therapeutic delivery mechanisms, resulting in enhanced pharmacodynamic success and diminished adverse effects. Currently, melanoma is marked by multifaceted mechanisms that interplay with drug resistance and enhanced metastatic propensity, providing a paradigm for exosome-mediated delivery. The advent of engineered exosomes poses an innovative delivery platform that transports diverse bioactive cargo such as DNA, lipids, proteins and mRNA, thereby modulating immune evasion, angiogenesis, pre-metastatic niche formation, tumor progression and therapeutic resistance. Beyond their biological functions, exosomes have emerged as potential minimally invasive biomarkers for melanoma prognosis, diagnosis and treatment monitoring owing to their biocompatibility, stability and capability to imitate the molecular profile of the primary tumor. The current developments in exosome engineering have marked their potential as natural nanocarriers in various therapeutic delivery approaches like chemotherapy, immunotherapy, radiotherapy and codelivery. The current review highlights the promising potential of exosome-based therapeutics as targeted therapeutics, prognostic and diagnostic biomarkers, and as a theranostic platform. Furthermore, the review critically analyzes current challenges associated with isolation and characterization of exosomes, safety, reproducibility, large-scale manufacturing and regulatory considerations of exosome-based therapeutics. Collectively, exosome-based strategies hold substantial potential for improving the diagnosis and management of melanoma, which may encourage the development of next-generation therapeutic interventions in the medical world.
Aashi Srivastava, Pooja Khairnar, Pallavi Chaure et al.· Colloids and Surfaces B: Bio...· 0 citations
The blood–brain barrier (BBB) remains a major biological obstacle limiting the effective delivery of therapeutics for central nervous system (CNS) disorders. Although conventional drug delivery approaches have achieved continuous advances, their clinical translation is frequently restricted by limited brain penetration, insufficient target specificity, and systemic adverse effects. Exosomes, endogenous extracellular vesicles (EVs) involved in intercellular communication, have emerged as promising candidates for CNS therapeutic delivery owing to their favorable biocompatibility, relatively low immunogenicity, and potential ability to interact with biological barriers. In this review, we first summarize the structural characteristics of the BBB and the mechanisms underlying exosome–BBB interactions and transport. We then discuss current strategies for exosome isolation, characterization, and engineering, highlighting how these approaches influence therapeutic performance and translational feasibility. Subsequently, we analyze recent advances in exosome-based therapies for major CNS disorders, including neurodegenerative diseases, brain tumors, and ischemic stroke, with emphasis on how distinct pathological environments guide the design of exosome cargos, targeting strategies, and functional modifications. Finally, we discuss key challenges associated with clinical translation, including manufacturing standardization, pharmacokinetic evaluation, safety assessment, and regulatory considerations. This review provides a pathology-driven and engineering-guided perspective for understanding the rational design and future development of exosome-based therapeutics for CNS disorders.
Qinzhen Cheng, Yalan Zhu, Shiwen Lv et al.· Bioactive Materials· 0 citations
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