Figure 4.

Examples of EVs surface functionalization strategies to improve cardiac targeting. Modification of EV surface can be performed before or after isolation. Regarding the first approach, donor cells are transfected/transduced to overexpress specific molecules that target cardiac epitopes on the released EV’s surface. On the other hand, different techniques can be used to incorporate cardiac-targeting molecules on the EV’s surface after isolation, such as fusion of EVs with monocyte membrane fragments by incubation/extrusion or conjugation of cardiac homing peptides via a dioleoylphosphatidylethanolamine N-hydroxysuccinimide (DOPE-NHS) linker.