Beyond nutrition: The emerging therapeutic potential landscape of breast milk-derived extracellular vesicles

Breastfeeding is widely recognized for its essential nutritional benefits and broader biological impacts. Beyond providing infants with a balanced mix of vitamins, proteins, and fats critical for growth and development, breast milk contains bioactive extracellular vesicles (BMEVs). These membrane-bound particles, rich in proteins, lipids, and nucleic acids, play a pivotal role in immune modulation, intercellular communication, and the overall development of the infant's immune system. This review explores the emerging therapeutic potential of BMEVs, highlighting their capacity to modulate recipient cell functions, influence immune responses, and contribute to overall infant health. Preclinical evidence suggests that these vesicles can prevent and manage conditions such as necrotizing enterocolitis, allergies, and viral infections, which are common in early childhood. Furthermore, BMEVs offer promise as vehicles for targeted drug delivery, enhancing the efficacy of therapeutic interventions. Despite the growing body of evidence, challenges such as the need for standardized isolation methods, characterization techniques, and larger-scale clinical studies persist, hindering the translation of this research into clinical practice. This review addresses these challenges and discusses future directions, emphasizing the need for comprehensive mechanistic studies to fully realize the potential of BMEVs as novel therapeutic agents and biomarkers of health. Ultimately, these vesicles represent a promising frontier in maternal and child health, with potential applications extending far beyond traditional nutrition. By harnessing their unique properties, BMEVs could revolutionize infant care, offering new strategies for disease prevention and innovative therapeutic interventions that enhance infant health outcomes.