The Application and Challenges of Stem Cell-Derived Extracellular Vesicles in Inhalation Lung Injury

Dandan Ling,1,* Ruidong Wang,2,* Jun Liu,3,* Jingwen Zhai,1 Jiani Chen,1 Yaqiong Li,1 Hong Liu,1 Zongguang Tai,3 Hua Wei1 1Department of Good Clinical Practice, Medical Guarantee Center, Second Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China; 2Clinical Research Institute, Department of Good Clinical Practice, Third Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China; 3Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hua Wei, Email wh7975@163.com Zongguang Tai, Email taizongguang@126.comAbstract: Inhalation-induced lung injury, caused by harmful factors like chemical fumes and dust, leads to acute and chronic inflammation and fibrosis. Traditional treatments, such as mechanical ventilation and anti-inflammatory drugs, can relieve symptoms but fail to promote tissue regeneration. Stem cells and their extracellular vesicles (EVs) offer new treatment possibilities due to their anti-inflammatory and regenerative properties. However, the specific pathological environment of these lung injuries limits the effectiveness and targeting of EVs, challenging their clinical use. This review outlines stem cell EVs’ mechanisms in treating inhalation-induced lung injury, examines recent engineering advancements, and addresses challenges in moving from research to clinical application. It highlights the importance of interdisciplinary collaboration in carrier design, production, and regulation, offering a theoretical foundation for developing precision EV-based treatments. Keywords: stem cells, extracellular vesicles, inhalation lung injury, optimization strategy, clinical translation