Extracellular vesicles in patients affected by burns: Unraveling clinical, immunological, and therapeutic dimensions

Following burn injury, the body activates a series of complex physiological pathways, notably inflammation, immune response, and tissue repair. Extracellular vesicles (EVs) have recently been identified as a key component in the pathophysiology of burn. Due to their capacity to transport bioactive elements such as proteins, metabolites, RNA, and cytokines, EVs play a crucial role in intercellular communication, including the immune response regulation following burn injuries. Recent research suggests that EVs may serve as valuable biomarkers for burn severity and prognosis, as well as help healing. However, EV production, composition, and function in severe burns remain largely unexplored. This review aims to summarize the current understanding of the specific roles of EVs in the pathophysiology of burn, with a particular focus on their involvement in immune regulation and tissue repair. We also discuss the present knowledge of the clinical implications of EVs, including the emerging evidence supporting the use of EVs as biomarkers for severity and prognosis of burned patients, along with the therapeutic potential of EVs in burn management. Finally, we highlight the current challenges in EV research and propose future directions to advance EV-based approaches in burn treatment. A deeper understanding of EV biology in burn injuries could pave the way for innovative diagnostic and therapeutic strategies in clinical practice.