Exosome-based therapeutics for restoring ovarian function in polycystic ovary syndrome: Mechanisms, translational potential, and future perspectives

Abstract

Exosomes are a distinct subset of extracellular vesicles (EVs) that have emerged as key regulators of intercellular communication. These vesicles, secreted by a wide array of cell types, are enclosed by a lipid bilayer and transport a diverse collection of biomolecules, including proteins, lipids, messenger RNAs (mRNAs), and microRNAs (miRNAs), reflecting the physiological or pathological condition of their source cells. The current review presents a detailed and comprehensive analysis of the biological processes involved in the formation of exosomes, together with their molecular composition, structure, and functions. The review also focuses on the increasing importance of exosomes in recent biomedical studies, especially in relation to their potential uses in the diagnosis and treatment of various diseases, such as cancers, neurodegenerative diseases, and diseases affecting the reproductive system. In particular, the review highlights the therapeutic relevance of exosomes in polycystic ovary syndrome (PCOS), where they modulate inflammation, oxidative stress, and hormonal imbalance, contributing to ovarian dysfunction. The review also discusses established and emerging techniques for exosome isolation and characterisation, as well as recent technological advancements to enhance isolation efficiency and specificity. Finally, it evaluates the translational potential of exosomes as diagnostic biomarkers and drug delivery vectors. Additionally, their role as nanoscale carriers with high biocompatibility and targeting potential further strengthens their applicability in precision medicine, while critically examining existing limitations and future directions for their clinical application.