Extracellular vesicle therapy in neurological disorders

Extracellular vesicles (EVs) are vital for cell-to-cell communication, transferring proteins, lipids, and nucleic acids in various physiological and pathological processes. They play crucial roles in immune modulation and tissue regeneration but are also involved in pathogenic conditions like inflammation and degenerative disorders. EVs have heterogeneous populations and cargo, with numerous subpopulations currently under investigations. EV therapy shows promise in stimulating tissue repair and serving as a drug delivery vehicle, offering advantages over cell therapy, such as ease of engineering and minimal risk of tumorigenesis. However, challenges remain, including inconsistent nomenclature, complex characterization, and underdeveloped large-scale production protocols. This review highlights the recent advances and significance of EVs heterogeneity, emphasizing the need for a better understanding of their roles in disease pathologies to develop tailored EV therapies for clinical applications in neurological disorders. This paper reviews recent advances in EV subpopulation and characterization. We discuss the potential of EVs to address multiple aspects of neurological diseases, including neuroinflammation, mitochondrial dysfunction, apoptosis, and blood-brain barrier leakage. The review emphasizes the complexity and heterogeneity of EVs, highlighting the need for better characterization and classification to optimize therapeutic applications. By understanding EV subtypes and their roles, we can develop more effective and tailored EV therapies for clinical use in treating neurological conditions.