The engineered bone marrow mesenchymal stem cell-derived exosome: A new strategy for the treatment of inflammatory...

Inflammatory diseases are characterized by chronic inflammation as the underlying pathogenic mechanism. Current treatments primarily rely on anti-inflammatory and glucocorticoid drugs to suppress inflammation, but these approaches often provide only symptomatic relief without promoting tissue repair. Bone marrow mesenchymal stem cells (BMSCs) have demonstrated significant therapeutic potential in inflammatory diseases due to their immunomodulatory properties, ability to promote tissue regeneration, and secretion of various bioactive factors. Recent studies have shown that BMSC-derived exosomes (BMSC-EXOs) possess similar therapeutic functions while overcoming several limitations associated with cell-based therapies, including ethical concerns, immunogenicity, and challenges related to in vitro culture and expansion. Furthermore, engineering strategies have enhanced the cargo capacity, targeting specificity, and circulation time of BMSC-EXOs, thereby improving their therapeutic efficacy in inflammatory conditions. This review summarizes the isolation methods, biological functions, and engineering approaches of BMSC-EXOs in the context of inflammatory diseases, aiming to inform future diagnostic and therapeutic strategies.