. 2024 Feb 5;9:27. doi: 10.1038/s41392-024-01735-1

Table 3.

Therapeutic applications of Extracellular vesicles

Molecule/Drugs	Source of EVs	Target model	Disease	Genes/Protein	Mechanism	References
EVs	Adipose tissue	Pancreatic islets C57BL/6J mice	Obese and Insulin-Resistance	GPCR, cAMP PKA	Enhances insulin secretion in T2D patients Mediators of obesity-associated Metabolic dysfunctions	^653,654
Exosomes and EVs	MSCs HFL1	T2DM using an HFD and STZ Primary human skeletal muscle cells	T2DM	GLUT4, p-GSK3β, PCNA, Caspase3	Maintain glucose homeostasis Relieves β-cell destruction Reverses peripheral insulin resistance	^539,655
EVs	Macrophages	miR-32^−/− mice, T2DM mice	T2DM	miR-32, Mef2d, cGMP-PKG	Autophagy inhibition of vascular smooth muscles	⁶⁵⁶
EVs carrying miRNAs	ADSCs	C57BL/KsJ db/m male mice	T2DM Nephropathy	TLR4, Bcl-2, caspase-3, Bax, IKKβ, IκBα, VEGFA	Protects Diabetic Nephropathy	⁶⁵⁷
Metformin	Urine	db/db mice on a high salt diet, mpkCCD cells	Diabetic Hypertension	cathepsin B, ENaC	Reducing high blood pressure	⁶⁵⁸
Dapagliflozin loaded exosomes	iPS-EC	Human iPSCs, iPS-ECs,	Diabetic Wound model	HIF-1α, VEGFA, C-X-C motif chemokine receptor 4	Facilitate angiogenesis Wound healing	⁶⁵⁹
EVs	Macrophage	M1 macrophage-induced HUVEC	Diabetic foot ulcer	miR-503, iNOS, Arg-1, IGF1R, ACO1	Regulates endothelial function affecting wound healing	⁶⁶⁰
EVs	Cardiomyocytes	ticagrelor-pretreated H9c2 cardiomyocytes HUVEC	Cardiovascular	Bnip3, Beclin, Bax, ENT1, miR-499, miR-133	Reduced hyperglycemia-induced ROS production Regulatory effect on diabetic cardiomyopathy	⁶⁶¹
Empagliflozin	MSCs	H9c2 cells, Myocardial infraction animal model	Cardiovascular disease	miR-214-3p, Bcl-2, BAX	Inhibited myocardial apoptosis Reduced infarct size improved cardiac function	⁶⁶²
EVs	MSCs	Dendritic cells from CD14⁺ cells T1DM mice	Type 1 Diabetes	IL-10, IL-6, IFN-γ, FOXP3⁺ regulatory T cells, Th1, Th17	anti-inflammatory cell therapy for autoimmune disease prevention	^663,664
EVs	2-E-EVs CoV-2	Vero E6 cells	COVID-19	nAb-1, nAb-2	Cell-to-cell transmission of SARS-CoV-2 Facilitates neutralizing antibody entry into cells	⁶⁶⁵
EVs	MSCs	COVID-19 patients THP1, Calu3, MVEC Rat model of LPS-induced ALI	COVID-19	ACE2, CD14, TLR4	Reduce morbidity and mortality Reduce lung inflammation	^666,667
iNSC-EVs	Neural stem cells	NSCs, iNSCs	Alzheimer’s disease	GFAP⁺, Tuj¹⁺ Iba¹⁺, Aβ_1-42	Therapeutic effects on cognitive function, neurodegeneration	⁶⁶⁸
EVs	Primary macrophages Neurons astrocytes	Neuronal cells, Parkin Q311X(A) mice	Neurodegenerative disorder	Tetraspanins, integrins	As nanocarriers for drug delivery to inflamed tissue	⁶⁶⁹
Vincristine (VCR)	Epidermoid carcinoma cells	KBv200 cells	Epidermoid carcinoma	ABCB1, Rab5, Rab8B	Increases sensitivity to chemotherapeutic drugs	⁶⁷⁰
Taxanes and Anthracyclines	Primary tumors BC cells	4T1 cells, C57BL/6, C57BL/6/Ccr2-KO mice,	Breast cancer	Anxa6, CCR2	Pro-metastatic Proinflammatory	⁶⁷¹
Paclitaxel (PTX)	PTX- BC cells	HUVECs MCF-7	Breast cancer	circBACH1, miR-217, G3BP2 axis.	CircBACH1/ miR-217/G3BP2 axis a new regulatory for PTX-resistance and progression of breast cancer.	⁶⁷²
Cisplatin	Ovarian cancer cells	A2780, IGROV-1 cells	Ovarian cancer	CREB, ERK, JNK, p38α, p53	inhibits ovarian cancer	^673,674
	Milk exosomes loaded with cisplatin	A2780, nu/nu mice	Ovarian cancer	ARF6, Rac1, CLTC, caveolin	Overcomes cisplatin-resistance in ovarian cancer
Temozolomide	Glioblastoma cells	U87-MG cells, GBM cells	Glioblastoma	Heat shock protein, RAD51, MDM2	Leads to cell adhesion	⁶⁷⁵
EVs encapsulated miR-153-3p	LUAD cells	NCI-H1993, SW1271, BALB/c mice,	Lung adenocarcinoma	BANCR, miR-153-3p, PI3K/AKT	Increases cell invasion	⁶⁷⁶
EVs	PDAC cells	MIA PaCa-2, PANC-1,Rag2^−/−Ilrg2^−/−, mice	Pancreatic ductal adenocarcinoma	Rab27a, LRP-4 receptor, YAP	Intratumor communication Targeted therapy for PDAC	⁶⁷⁷
EVs	Human Liver Stem Cells MSCs	Renal cancer cells SCID mice	Renal cell carcinoma	miR-Let7b, miR-200b, miR-200c and miR-223, EGFR, ZEB1, ZEB2, MMP1	antitumor effects	⁶⁷⁸