Advanced cell-derived drug delivery systems for pulmonary diseases: from bench to bedside

Nowadays, pulmonary diseases (PDs) are among the leading causes of mortality worldwide. Conventional therapeutic approaches exhibit disappointing efficacies due to difficulty in drug delivery and systemic cytotoxicity. In recent years, novel formulations of therapeutic drugs rised as alternatives for clinical treatment. Among them, cell-derived drug delivery systems (CDDSs) have garnered attention for their potential in treating PDs. By harnessing the innate migratory capabilities, barrier-crossing potential, high biocompatibility, and substantial drug-loading capacity of cell derivatives, CDDSs offer a promising approach for PD treatment. However, there was no systemic report in summarizing CDDSs in PDs. In this review, We first examined the biological properties and therapeutic advantages of various CDDSs in the context of PDs, including red blood cells (RBCs), stem cells, platelets, macrophages, neutrophils, tumor cells, microalgae, extracellular vesicles (EVs) and biomimetic cell membrane. We then discussed common preparation strategies and different modification methods of CDDSs. Finally, we summarized the current therapeutic advancements of CDDSs in multiple PDs. We hope this review serves as a valuable reference for utilizing CDDSs in the treatment of PDs and other diseases.