Plant-Derived Exosome-Like Nanovesicles for CNS Drug Delivery and Gut–Brain Axis Modulation: A Narrative Review

Le Ding,1 Qiong Bian,2 Xiaozhou Mou,1 Xiaoru Chang1 1Department of Neurology, Center for Rehabilitation Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Dermatology, Center for Plastic & Reconstructive Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiaozhou Mou, Email [email protected] Xiaoru Chang, Email [email protected]: As global population aging intensifies, the incidence of central nervous system (CNS) disorders escalates, while obstacles like the blood-brain barrier (BBB) impede effective medication delivery. Plant-derived exosome-like nanovesicles (PELNVs), as innovative therapeutic carrier, have garnered significant interest in their capacity to transport medications across the BBB. A substantial emphasis is focused on the diverse therapeutic potential of PELNVs, underscoring their direct neuroprotective, anti-inflammatory, and antioxidant properties, along with their nascent function in altering the gut-brain axis to indirectly mitigate neuroinflammation. We subsequently compile information elucidating the processes by which PELNVs transport therapeutic cargo to the brain, including receptor-mediated transcytosis and their tailored targeting techniques. Ultimately, we address the prevailing difficulties. In summary, PELNVs embody a revolutionary, multi-faceted strategy with significant promise to address the persistent challenges in CNS medication delivery and treatment. Keywords: plant-derived exosome-like nanovesicles, drug delivery, gut-brain axis, gut microbiota