Mesenchymal stromal cell extracellular vesicles as immune modulators and drug carriers in neurodegenerative disorders

Mesenchymal stromal cells (MSCs) hold significant therapeutic potential, but their clinical application is often hindered by limitations such as donor variability. MSC-derived extracellular vesicles (EVs) present a promising alternative, offering comparable or superior therapeutic effects while overcoming some of these challenges. MSC-EVs exhibit strong anti-inflammatory and immunomodulatory properties, which could be leveraged in neurodegenerative diseases given the central role of neuroinflammation in these conditions. Additionally, MSC-EVs can be engineered for targeted drug delivery, enhancing their clinical utility. In this review we highlight the dual role of MSC-EVs as immunomodulators and drug carriers in neurodegenerative disorders. We discuss the current challenges, and outline strategies for clinical translation. Future advances in understanding MSC-EVs and their mechanisms of action could support their development into effective therapies for neurodegenerative diseases.