Targeted Delivery of Extracellular Vesicles: The Mechanisms, Techniques and Therapeutic Applications

Extracellular vesicles (EVs) have significant therapeutic potential, but their clinical application is hindered by challenges such as natural biodistribution and short plasma half-life. Recent advancements in engineering EVs for targeted delivery have improved therapeutic efficacy by enhancing their targeting to lesion sites. This review discusses various targeting mechanisms, including tissue marker recognition and external stimuli like magnetic fields, as well as engineering techniques such as genetic engineering and chemical modification. A comparative analysis of these techniques highlights differences in size, stability, and efficacy. The review also summarizes clinical trials from 2010 to 2023, advocating for further exploration and clinical application of engineered EVs.