Photobiomodulation-enhanced exosomes: mechanisms, therapeutic potential, and emerging engineering strategies

Photobiomodulation (PBM) and extracellular vesicles (EVs), particularly exosomes derived from mesenchymal stem cells (MSCs), have independently emerged as promising tools in regenerative medicine.Growing evidence suggests that PBM can modulate the MSC physiology by enhancing the mitochondrial activity, regulating redoxdependent transcription, and reducing inflammation.These cellular responses align with the key steps in exosome biogenesis, supporting the observations that PBM increases EV secretion without compromising structural integrity.The PBM-primed exosomes may exhibit improved biological activity, even though comprehensive cargo profiling remains limited.Therapeutic applications across wound repair, inflammation control, neuroprotection, and hair regeneration reveal a mechanistic rationale for PBM-enhanced EVs, even as direct in vivo data are still sparse.Furthermore, PBM may synergize with EV-based therapies by conditioning injured tissues to enhance vesicle uptake and functional efficacy.Advances in optical dosing technologies, single-vesicle analytics, multi-omics profiling, and scalable biomanufacturing systems now provide the technical foundation for developing PBM-engineered EV therapeutics.Despite these opportunities, significant challenges remain, including incomplete mechanistic elucidation, inconsistent PBM parameters, and the absence of rigorous preclinical combination studies.Therefore, continued investigation will be needed to define how PBM reshapes EV biogenesis and function, and establish clinically actionable PBM-EV therapeutic strategies.