Extracellular Vesicles as Key SASP Carriers Driving Cellular Senescence, Inflammaging, and Therapeutic Opportunities in Aging and Age-Related Diseases

The progressive decline in physiological processes with aging is a complex biological process that increases susceptibility to age-related diseases. Cellular senescence is a primary contributor to this process, a state of sustained cell cycle arrest accompanied by a distinctive secretory profile known as the Senescence-Associated Secretory Phenotype (SASP). In recent years, extracellular vesicles (EVs), including exosomes and microvesicles (MVs), have emerged as key mediators of intercellular communication by carrying bioactive molecules, such as proteins, lipids, and nucleic acids. In this review, we describe how EVs are important SASP vectors that transmit senescent signals to nearby cells, driving immunosenescence, persistent inflammation (inflammaging), and other aging characteristics, such as stem cell exhaustion and genomic instability. Furthermore, we highlight the dual function of EVs as both pathogenic drivers of aging-related dysfunctions and promising therapeutic agents. In addition, we emphasize their potential as diagnostic biomarkers for age-related diseases, including cardiovascular disease, osteoporosis, and Alzheimer's disease. Finally, we explore the emerging therapeutic uses of EVs, particularly those derived from mesenchymal stem cells (MSCs), to promote tissue repair, reduce aging phenotypes, and serve as engineered drug-delivery systems. This study highlights the critical role of EVs in aging mechanisms and establishes them as potent diagnostic and therapeutic tools for anti-aging.