Extracellular Vesicles in Drug Delivery: From Quality Assurance to Therapeutic Application

Developing optimal drug delivery carriers to enhance the pharmacokinetics of therapeutic agents and mitigate toxicity to normal cells remains a pivotal focus in medical research. Extracellular vesicles (EVs) have emerged as a highly promising platform for drug delivery, owing to their unique biological properties. Through intrinsic biogenesis pathways, EVs can selectively encapsulate genetic material, proteins, cytokines, and other bioactive components from donor cells. They subsequently mediate intercellular communication and regulate target cell behavior via humoral transport, surface protein interactions, membrane fusion, and other mechanisms-biological features that lay the foundation for their potential in therapeutic delivery. In recent years, EVs have attracted tremendous research interest due to their excellent biocompatibility, nanoscale size, low immunogenicity, facile modifiability, and versatile capacity to load various therapeutic agents. In this review, we analyse strategies for improving the quality control of drug-loaded EVs across multiple dimensions, specifically including the selection of EVs sources, control of isolation and purification, control of drug-loading strategies, and evaluation strategies after EVs drug loading, we also report the latest preclinical and clinical studies on the use of EVs as drug delivery systems for small-molecule drugs, nucleic acids, and proteins in disease treatment.