Exosome-Based Drug Delivery: Translation from Bench to Clinic

Abstract

Exosome-based drug delivery is emerging as a promising field with the potential to revolutionize therapeutic interventions. Exosomes, which are small extracellular vesicles released by various cell types, have attracted significant attention due to their unique properties and natural ability to transport bioactive molecules. These nano-sized vesicles, ranging in size from 30 to 150 nm, can effectively transport a variety of cargoes, including proteins, nucleic acids, and lipids. Compared to traditional drug delivery systems, exosomes exhibit unique biocompatibility, low immunogenicity, and reduced toxicity. In addition, exosomes can be designed and tailored to improve targeting efficiency, cargo loading capacity, and stability, paving the way for personalized medicine and precision therapy. However, despite the promising potential of exosome-based drug delivery, its clinical application remains challenging due to limitations in exosome isolation and purification, low loading efficiency of therapeutic cargoes, insufficient targeted delivery, and rapid elimination in circulation. This comprehensive review focuses on the transition of exosome-based drug delivery from the bench to clinic, highlighting key aspects, such as exosome structure and biogenesis, cargo loading methods, surface engineering techniques, and clinical applications. It also discusses challenges and prospects in this emerging field.

Synergistic Phototherapy-Molecular Targeted Therapy Combined with Tumor Exosome Nanoparticles for Oral Squamous Cell Carcinoma Treatment

“…ICG and Gefitinib are FDA-approved pharmaceuticals for human use, ensuring their superior biosafety. Moreover, exosomes, as bioinspired nanocarriers, exhibit intrinsic biocompatibility, biodegradability, and low immunogenicity as compared with artificially synthesized organic polymers and inorganic nanoparticles [ 56 ]. In fact, at least six exosome-based therapeutics have proceeded into phase I/II clinical trials for drug delivery [ 57 ].…”

Research Advances of Engineered Exosomes as Drug Delivery Carrier

“…Therefore, the safety and efficacy of different sources of exosomes need to be further evaluated rather than simply acting as empty carriers. For example, tumor cell-derived exosomes are commonly researched for improving the targeting efficiency against cancer cells, but their potential carcinogenic risk must be considered . Despite the challenges, the unique properties of exosomes have attracted extensive attention of many researchers.…”

“…For example, tumor cell-derived exosomes are commonly researched for improving the targeting efficiency against cancer cells, but their potential carcinogenic risk must be considered. 161 Despite the challenges, the unique properties of exosomes have attracted extensive attention of many researchers. Exosomes from plant and milk sources have been explored as a relatively economical alternative option.…”

Exosome-Mediated Antigen Delivery: Unveiling Novel Strategies in Viral Infection Control and Vaccine Design

“…Difficulties in isolating and purifying exosomes pose significant hurdles. Moreover, the low efficiency in loading therapeutic cargoes, attributed to the intrinsic loading of exosomes with numerous proteins and nucleic acids, coupled with their rapid elimination from circulation, further complicates their clinical utility [ 237 ]. To address these challenges, consideration may be given to synthetic delivery systems, such as liposomes [ 238 ].…”