Extracellular Vesicles: An Emerging Tool in Inflammatory Bowel Disease

Document Type : Review Article

Authors

1 Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Iranian Cancer Control Center (MACSA), Tehran, Iran

3 Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran

Abstract

Inflammatory bowel disease is a group of chronic and recurrent autoimmune diseases that engage the gastrointestinal tract, including ulcerative colitis and Crohn's disease. Advances in understanding disease pathology have led to the development of new therapeutic approaches. For instance, extracellular vesicles have attracted clinicians due to their crucial roles in keeping intestinal epithelial barrier integrity and interactions with microbiota. Extracellular vesicles are potentially useful in drug delivery on account of their natural origin, low toxicity, stability in the bloodstream, limited immunogenicity, ability to breach biological barriers, and capability to target specific cells. In another aspect, extracellular vesicles as a therapeutic tool can reduce inflammation in colitis by decreasing pro-inflammatory, increasing anti-inflammatory cytokine levels, and inhibiting the NF-κB signaling pathway. Moreover, the interaction between gut microbiota and the intestine can affect the development of inflammatory bowel disease. Extracellular vesicles derived from probiotics, commensal bacteria, and parasites potentially treat inflammatory bowel disease. Despite their benefits, several challenges hinder exosome-based therapies, including low production yields, high costs of large-scale cell culture, limited cargo transport efficiency, and difficulties in quality control due to exosome heterogeneity. Further, evidence of the role of extracellular vesicles in the treatment of inflammatory bowel disease is confined to in vitro models and in vivo studies; thus, the research is at an early stage. The next significant step in extracellular vesicle research will be the translation of the approach into human clinical trials to confirm the findings and explore their therapeutic potential in inflammatory bowel disease.

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Regenerative Biomedicine
Volume 1, Issue 3
July 2025
Pages 155-171

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