Bioengineering Applications of Chinese Herbal Medicine-Derived Exosomes in Cardiovascular Diseases: Mechanisms and...

Cardiovascular disease remains the leading cause of death worldwide, with current therapies facing limitations in efficacy and safety. Chinese Herbal Medicine-Derived Exosomes (CHM-Exos) are nano-sized membrane vesicles secreted by herbal cells, capable of cross-species delivery of bioactive substances. While plant-derived extracellular vesicles have been extensively reviewed, analyses specifically focused on CHM-Exos in cardiovascular contexts remain limited. This review systematically examines the bioengineering applications and therapeutic mechanisms of CHM-Exos in cardiovascular diseases, addressing a critical gap in translational literature. Mechanistically, CHM-Exos show potential to alleviate oxidative stress and modulate vascular cell function, though direct cardiovascular evidence remains preliminary. Key translational barriers-including standardization challenges, scalability constraints, and regulatory uncertainties-are critically discussed, alongside strategies to advance these promising nanocarriers toward clinical application.