The role of exosomes in immune cell function and regulation during organ transplantation

Organ transplantation serves as a vital therapeutic option for individuals suffering from end-stage organ failure. Nevertheless, immune-mediated rejection remains a major obstacle to achieving long-term graft survival and a favorable patient prognosis. This review examines the growing significance of exosomes-nanoscale extracellular vesicles with biological activity-in the regulation of transplant-related immunity. By shuttling bioactive cargo, these vesicles enable precise cell-to-cell communication and bidirectionally influence immune cell activity. Such processes can either promote graft rejection or facilitate tolerance. A systematic exploration of the mechanisms behind exosome-driven immunomodulation reveals their promising ability to overcome drawbacks associated with current treatments, including immunosuppressive drugs and mesenchymal stem cell therapy. Owing to their low immunogenicity and capacity for bioengineering, exosomes exhibit distinctive biological features that support their use as a groundbreaking strategy for improving transplantation success.