Computational frameworks for enhanced extracellular vesicle biomarker discovery

Extracellular vesicles (EVs) are emerging as promising noninvasive biomarkers, yet their clinical translation faces substantial hurdles, primarily due to the challenge of identifying assay-compatible markers. Here, in this Review, we outline sophisticated computational frameworks, particularly leveraging artificial intelligence, to bridge this gap. We detail the integration of diverse data resources, including disease-specific omics, EV, protein localization, tissue-specific, drug, model system and immune databases. This Review comprehensively describes computational selection strategies, from rule-based sequential filtering to advanced machine learning for data fusion and deep learning for multi-omics integration. Crucially, it discusses the refinement of biomarker candidates using artificial-intelligence-driven predictions of protein structure and physicochemical properties, ensuring compatibility with existing assay systems. By systematically evaluating biomarkers for predictive performance, biological plausibility and clinical utility, this framework aims to accelerate the transition of EV research from discovery to clinical application, thereby enhancing precision medicine.