Tiny carriers, big impact: How <i>Fusobacterium nucleatum</i> extracellular vesicles drive oral diseases and beyond

Abstract Fusobacterium nucleatum ( F . nucleatum ), recognized for its opportunistic pathogenicity, is a prevalent pathogen implicated in several diseases. Emerging evidence highlights the crucial role of F . nucleatum –derived extracellular vesicles ( F . nucleatum EVs) in mediating virulence and serving as carriers of diverse bioactive components that facilitate host–pathogen interactions. F . nucleatum EVs can disseminate from the oral cavity to the gastrointestinal tract and joints, promoting the onset and progression of oral inflammatory diseases, head and neck squamous cell carcinoma, rheumatoid arthritis, inflammatory bowel disease, and colorectal cancer through various signaling pathways. A deeper understanding of F . nucleatum EVs will advance the understanding of the pathogenesis of related diseases and inform the development of effective infection control strategies. This review systematically summarizes recent progress in the biogenesis, molecular composition, and pathogenic roles of F . nucleatum EVs across various disease contexts and evaluates potential strategies for the diagnosis, treatment, and management of conditions involving F . nucleatum and its EVs.