Therapeutic Applications and Advancements of Exosome-Based Treatments - A Comprehensive Review

Abstract: As tiny extracellular vesicles ranging 30–150 nm in size, exosomes are crucial for cell-to-cell communication and show great promise in therapeutic applications. All cell types release lipid bilayer-enclosed vesicles that carry bioactive molecules such as proteins, lipids, and nucleic acids, which reveal the health conditions of their originating cells. Exosome-based therapeutics have developed rapidly over the past decade due to their natural biocompatibility and minimal immune response, with the added benefit of traversing biological barriers such as the blood-brain barrier. This review presents a thorough critical synthesis of current developments in the development and use of therapies based on exosomes. This article explores basic exosome biology alongside methods for their isolation and characterization, as well as describes bioengineering approaches used to enhance their therapeutic capabilities. This review highlights their clinical applications, specifically in oncological treatments and therapies targeting neurodegenerative conditions, cardiovascular disorders, and regenerative medicine procedures. This review explores current clinical trials of exosome-based therapies and discusses manufacturing obstacles and regulatory frameworks, along with ethical issues that influence the development of exosome- based treatments. This chapter concludes by examining the future prospects of synthetic exosome mimetics and artificial exosome engineering, which will transform exosomes into the leading edge of next-generation nanomedicine.