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Herein, ginger\u2010derived exosomes (G\u2010Exos) loaded with berberine (G\u2010Exos@B) to facilitate targeted delivery to the liver through the formation of GR\u2010Exos@B via the coalescence of ursodeoxycholic acid (UDCA)\u2010introduced liposomes (RAL) for effective NASH intervention are developed. The introduction of G\u2010Exos significantly equipped GR\u2010Exos@B to effectively overcome the multi\u2010intestinal barrier, facilitating their exit from the cell in an intact form. Interestingly, the hepatic\u2010targeting of RAL allowed GR\u2010Exos to penetrate the liver more effectively than G\u2010Exos, resulting in 2.39\u2010fold greater accumulation in the liver. In vivo experiments revealed that dual ROS depletion by berberine and GR\u2010Exos synergistically enhanced the therapeutic effect against inhibited oxidative stress and hepatocellular steatosis compared to GR\u2010Exos. Additionally, the macrophage\u2010targeting capability of G\u2010Exos is leveraged to suppress the activation of hepatic NLRP3 inflammasome complexes, transitioning from an M1 pro\u2010inflammatory to an M2 anti\u2010inflammatory state, which helped diminish hepatic macrophage levels and subsequently reduce lipid accumulation. Meanwhile, GR\u2010Exos@B improved insulin sensitivity primarily by strengthening the AMPK\/AKT\/IRS\u20101 signaling pathway and inhibiting GSK3\u2010\u03b2 function. Hence, GR\u2010Exos@B shows promise as a potential strategy for alleviating obesity\u2010induced NASH therapy.<\/jats:p>","DOI":"10.1002\/adhm.202503076","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T08:31:15Z","timestamp":1759221075000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hepatic\u2010Targeted Liposomes\u2010Ginger\u2010Derived Exosomes Hybrid Nanocarrier for Synergistic Alleviation of Obesity\u2010Induced Nonalcoholic Steatohepatitis"],"prefix":"10.1002","volume":"15","author":[{"given":"Yuhong","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Engineering School of Engineering China Pharmaceutical University  Nanjing 211198 P. R. 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