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Probiotic-derived extracellular vesicles: the next breakthrough in postbiotics for rheumatoid arthritis

Federica Dell'Atti1,2, Hugo Abreu1,2, Patrizia Malfa3

  • 1Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Università del Piemonte Orientale, Novara, Italy.

Frontiers in Immunology
|August 25, 2025
PubMed

Insights

Probiotic-derived extracellular vesicles (EVs) show therapeutic potential for rheumatoid arthritis (RA) by modulating immune responses and reducing inflammation. Further research into EVs could lead to breakthroughs in postbiotic treatments for RA.

Area of Science:

  • Immunology
  • Microbiology
  • Biotechnology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease involving systemic inflammation and joint damage.
  • Gut and oral microbiota dysbiosis is implicated in RA pathogenesis, potentially worsening inflammation and immune dysregulation.
  • Probiotics show promise for RA, but cell-free alternatives like postbiotics, including probiotic-derived extracellular vesicles (EVs), offer a novel therapeutic avenue.

Purpose of the Study:

  • To review the therapeutic potential of probiotic-derived extracellular vesicles (EVs) for rheumatoid arthritis (RA).
  • To examine the interaction of EVs with host immune cells and their subsequent immune modulation.
  • To discuss the challenges and future directions for using EVs in RA treatment and personalized medicine.

Main Methods:

  • Review of existing literature on probiotic-derived EVs, their mechanisms of action, and their role in immune modulation.
  • Analysis of how EVs interact with immune cells, such as promoting M2 macrophage polarization and suppressing pro-inflammatory cytokines.
  • Exploration of omics sciences and biotechnology advancements for optimizing EV production and application.

Main Results:

  • Probiotic-derived EVs can modulate immune responses, reduce inflammation, and restore gut barrier integrity.
  • EVs demonstrate potential in suppressing pro-inflammatory cytokines and promoting anti-inflammatory M2 macrophage polarization.
  • The therapeutic efficacy of EVs is influenced by their interaction with host immune cells.

Conclusions:

  • Probiotic-derived EVs represent a promising postbiotic therapy for rheumatoid arthritis (RA) due to their immunomodulatory properties.
  • Challenges in standardization, administration, and clinical safety need to be addressed for widespread clinical application.
  • Advancements in biotechnology and omics sciences are key to unlocking the full potential of EVs for personalized RA treatment.
Keywords:
arthritisdysbiosisextracellular vesiclesimmunomodulationinflammationoral-gut-joint axisprobioticstherapeutic strategies

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