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They serve as key mediators of intercellular communication by transporting a broad repertoire of proteins, lipids, nucleic acids, and metabolites to recipient cells within a protective lipid bilayer. Owing to their natural origin, intrinsic stability, low immunogenicity, and ability to cross biological barriers, EVs are highly attractive candidates for next-generation therapeutics and drug delivery platforms. In this review, we summarize the biology of EVs and highlight the features critical for their application in therapeutic delivery. We trace their multiple origins, ranging from mammalian and plant cells to bacteria, underscoring their ubiquity across biological systems. We then analyze the advantages of EVs as next-generation delivery vehicles. From a practical standpoint, we examine current strategies for EV isolation, purification, characterization, and engineering. Importantly, we showcase several therapeutic applications of EVs for intractable diseases that are refractory to conventional approaches, such as cancer and immune disorders. We also discuss the major challenges on the path to clinical translation, particularly scalable and standardized production, as well as safety and immunogenicity. To fully realize the clinical potential of EV-based therapies, future research should prioritize the development of robust manufacturing protocols and comprehensive safety evaluations.<\/jats:p>","DOI":"10.1186\/s43556-026-00571-9","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:09:03Z","timestamp":1788919743000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extracellular vesicles for next-gen therapeutics and drug delivery"],"prefix":"10.1186","volume":"7","author":[{"given":"Nawaz","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynab","family":"Ahmadova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayyab","family":"Shafiq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0860-4859","authenticated-orcid":false,"given":"Yujie","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3638-8102","authenticated-orcid":false,"given":"Li","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"5","key":"571_CR1","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1038\/s41580-022-00460-3","volume":"23","author":"G Van Niel","year":"2022","unstructured":"Van Niel G, Carter DRF, Clayton A, Lambert DW, Raposo G, Vader P. 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