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Immunosuppressants like glucocorticoids (GCs) are used to regulate the immune microenvironment in clinical treatment, but the lack of safe and efficient tissue\u2010specific drug delivery systems, especially immune cell\u2010specific vectors, limits their widespread clinical application. Here, a previously uncharacterized delivery system is reported, termed GC\u2010Exo\u2010CD16Ab, in which GCs are loaded into purified exosomes derived from human umbilical cord mesenchymal stem cells, and subsequently decorated with antibody CD16Ab. GC\u2010Exo\u2010CD16Ab is biocompatible and has remarkable delivery efficiency toward CD16\n                    <jats:sup>+<\/jats:sup>\n                    decidual natural killer (NK) cells and CD16\n                    <jats:sup>+<\/jats:sup>\n                    macrophages in mice. This innovative approach effectively suppresses the cytotoxicity of decidual NK cells, inhibits M1 macrophage polarization, and regulates the decidual microenvironment, thereby enhancing placental and fetal morphology, and ultimately mitigating miscarriage risk in the abortion\u2010prone mice. The developed GC\u2010Exo\u2010CD16Ab provides a feasible platform for precise and tissue\u2010specific therapeutic strategies for miscarriage and pregnancy\u2010related diseases.\n                  <\/jats:p>","DOI":"10.1002\/advs.202406370","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T04:55:18Z","timestamp":1723524918000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Targeting Decidual CD16\n                    <sup>+<\/sup>\n                    Immune Cells with Exosome\u2010Based Glucocorticoid Nanoparticles for Miscarriage"],"prefix":"10.1002","volume":"12","author":[{"given":"Linlin","family":"Wang","sequence":"first","affiliation":[{"name":"Reproductive Medicine Center Department of Obstetrics and Gynecology Renmin Hospital of Wuhan University Wuhan University  Wuhan 430072 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