Progress of research on engineered extracellular vesicles from different sources for disease treatment

Extracellular vesicles (EVs) are lipid bilayer nanoparticles that encapsulate proteins, lipids, nucleic acids, and small molecules and display low immunogenicity, high stability, and cross-species transmission. By applying engineering technologies, the surface of EVs can be modified and loaded with cargo with therapeutic properties. Thus, engineered EVs can play important roles in preventing and treating various diseases. However, many challenges and uncertainties are faced in the clinical translation of EVs. In this review, we comprehensively analyzed the types of EVs derived from animal cells, plant cells, and microorganisms and summarized their biological properties and potential for engineering modifications. Furthermore, we also explored their therapeutic potential and discussed recent advancements in relevant clinical trials, aiming to provide scientific guidance for future research on the engineering of EVs and precision treatment of clinical diseases.