[Research progress on the application of extracellular vesicle in severe pneumonia]

Extracellular vesicle (EV), nanoscale membrane-bound structures actively secreted by cells, are enriched with bioactive molecules such as proteins and microRNAs (miRNA). It plays a pivotal role in regulating inflammation, immune balance, and tissue regeneration during both physiological and pathological processes. In the pathogenesis of severe pneumonia, EV is not merely involved in disease progression but also exhibit specific molecular signatures that can serve as novel biomarkers, offering crucial insights for early diagnosis, disease staging, and prognostic assessment. In recent years, researchers have uncovered the potential of EV in developing targeted drug delivery systems and antibiotic susceptibility testing platforms, particularly for mitigating pulmonary inflammation and accelerating alveolar repair. Notably, as intelligent drug carriers and immune modulatory platforms, EV offers new strategies for implementing precision medicine strategies. However, their clinical translation faces multiple technical bottlenecks, including the standardization of isolation and purification protocols, comprehensive biosafety evaluations, and the establishment of clear ethical regulations. Future research should prioritize overcoming these critical challenges to facilitate the translational application of EV in severe pneumonia and other respiratory diseases. This article reviews the latest research progress on the application of EV in the clinical diagnosis and treatment of severe pneumonia. It focuses on the relevant mechanisms of EV in severe pneumonia, the clinical application of EV in the diagnosis of severe pneumonia, the clinical citation of EV in the treatment of severe pneumonia, the future research directions and application prospects of EV, as well as the challenges and solutions in clinical translation. The aim is to advance the development of precise diagnostics, optimize therapeutic strategies, and foster coordinated innovation across multiple disciplines.