The Role of Gut Microbiota-Derived Extracellular Vesicles in Post-Anesthesia Neuroinflammation and Cognitive Impairment

Neuroinflammation and cognitive impairment during the perioperative period significantly affect patient recovery, making them critical targets for therapeutic intervention. Recently, there has been growing interest in gut-derived exosomes (bacterial extracellular vesicles, BEVs) and their potential to modulate the central nervous system. The gut-brain axis, a vital pathway linking the gut to the central nervous system, offers a unique lens through which to explore the role of BEVs in nerve regeneration. This study investigates the biological properties and functions of BEVs during the perioperative period, focusing on their mechanisms in promoting post-anesthesia nerve recovery, including anti-inflammatory effects, neurotrophic support, and metabolic reprogramming. Additionally, the study explores potential BEV-based therapeutic approaches, current challenges in research, and future directions, aiming to provide novel insights and rationales for clinical application.