{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:06:57Z","timestamp":1789189617872,"version":"build-2803163510"},"reference-count":139,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["R56HL163607"],"award-info":[{"award-number":["R56HL163607"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"award":["R56HL163607"],"award-info":[{"award-number":["R56HL163607"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Issues Mol. Biol.","CIMB"],"abstract":"<jats:p>Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), exposed critical gaps in global preparedness for rapidly evolving viral pandemics. Though current antiviral treatments have shown some efficacy in managing COVID-19, substantial limitations, such as inefficient targeted drug delivery, aberrant host immune responses, and inadequate preparedness for future viral pandemics, were also evident. These challenges underscore the urgent need for target-specific, precise and efficient therapeutic strategies to modulate viral entry and immune dysregulation. Extracellular vesicles (EVs), cell-released cargo-carrying nanoscale vesicles, can both facilitate and inhibit viral infection depending on their cargo composition. Thus, endogenous EVs can promote or inhibit COVID-19 pathogenesis by modulating critical pathways, including angiotensin-converting enzyme 2 (ACE2)-mediated viral entry, transmembrane protease serine 2 (TMPRSS2)- dependent spike protein activation, nuclear factor kappa B (NF-\u03baB)-driven inflammatory signaling, and NLRP3 inflammasome activation. In contrast, engineered EVs, such as ACE2-expressing EVs, mesenchymal stem cell-derived EVs and microRNA-enriched EVs, have therapeutic potential as they can facilitate antiviral defense through immune modulation, viral neutralization and suppression of cytokine storm. Moreover, EV-associated nucleic acids, proteins and lipids can act as biomarkers for disease detection and severity stratification. A deeper understanding of EV-virus mechanistic insights can enhance preparedness for similar viral diseases. In this review, we provide a comprehensive analysis of the molecular mechanisms underlying EV-virus interactions highlighting the therapeutic and diagnostic potential of EVs in tackling COVID-19 and future viral pandemics.<\/jats:p>","DOI":"10.3390\/cimb48090924","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:27:21Z","timestamp":1789036041000},"page":"924","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracellular Vesicles as Molecular Regulators of Viral Infection: Implications for COVID-19 and Future Viral Pandemics"],"prefix":"10.3390","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4377-5706","authenticated-orcid":false,"given":"Saugata","family":"Dutta","sequence":"first","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sauradeep","family":"Dutta","sequence":"additional","affiliation":[{"name":"Yogananda School of AI, Computer and Data Science, Shoolini University, Solan 173229, Himachal Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohan","family":"Han","sequence":"additional","affiliation":[{"name":"Institute of Wonkwang Medical Science and Department of Microbiology, Wonkwang University School of Medicine, Iksan 54538, Jeonbuk, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4353-6043","authenticated-orcid":false,"given":"Sultan","family":"Almuntashiri","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, University of Ha\u2019il, Ha\u2019il 55473, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3017-0230","authenticated-orcid":false,"given":"Payaningal R.","family":"Somanath","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Priya","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheen","family":"Islam","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9900-740X","authenticated-orcid":false,"given":"Xiaoyun","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0361-4174","authenticated-orcid":false,"given":"Duo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA"},{"name":"Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, April 26). WHO COVID-19 Dashboard. Available online: https:\/\/data.who.int\/dashboards\/covid19."},{"key":"ref_2","first-page":"1770","article-title":"Vaccination to reduce severe COVID-19 and mortality in COVID-19 patients: A systematic review and meta-analysis","volume":"26","author":"Huang","year":"2022","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1056\/NEJMoa2118542","article-title":"Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with COVID-19","volume":"386","author":"Hammond","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"McFann, K., Baxter, B.A., LaVergne, S.M., Stromberg, S., Berry, K., Tipton, M., Haberman, J., Ladd, J., Webb, T.L., and Dunn, J.A. (2021). Quality of Life (QoL) Is Reduced in Those with Severe COVID-19 Disease, Post-Acute Sequelae of COVID-19, and Hospitalization in United States Adults from Northern Colorado. Int. J. Env. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111048"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1038\/s41579-021-00573-0","article-title":"SARS-CoV-2 variants, spike mutations and immune escape","volume":"19","author":"Harvey","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1038\/s41586-021-04385-3","article-title":"Omicron escapes the majority of existing SARS-CoV-2 neutralizing antibodies","volume":"602","author":"Cao","year":"2022","journal-title":"Nature"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.immuni.2020.05.002","article-title":"Immunology of COVID-19: Current State of the Science","volume":"52","author":"Vabret","year":"2020","journal-title":"Immunity"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jconrel.2017.01.011","article-title":"Drug Delivery Research for the Future: Expanding the Nano Horizons and Beyond","volume":"246","author":"Mitragotri","year":"2017","journal-title":"J. Control. Release"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1535750","DOI":"10.1080\/20013078.2018.1535750","article-title":"Minimal information for studies of extracellular vesicles 2018 (MISEV2018): A position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines","volume":"7","author":"Thery","year":"2018","journal-title":"J. Extracell. Vesicles"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"eaau6977","DOI":"10.1126\/science.aau6977","article-title":"The biology, function, and biomedical applications of exosomes","volume":"367","author":"Kalluri","year":"2020","journal-title":"Science"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1038\/nrd3978","article-title":"Extracellular vesicles: Biology and emerging therapeutic opportunities","volume":"12","author":"Mager","year":"2013","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.addr.2016.02.006","article-title":"Extracellular vesicles for drug delivery","volume":"106","author":"Vader","year":"2016","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9155","DOI":"10.1073\/pnas.1605146113","article-title":"Extracellular vesicles and viruses: Are they close relatives?","volume":"113","author":"Cremer","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e2206095","DOI":"10.1002\/advs.202206095","article-title":"A Review of Extracellular Vesicles in COVID-19 Diagnosis, Treatment, and Prevention","volume":"10","author":"Su","year":"2023","journal-title":"Adv. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Tahyra, A.S.C., Calado, R.T., and Almeida, F. (2022). The Role of Extracellular Vesicles in COVID-19 Pathology. Cells, 11.","DOI":"10.3390\/cells11162496"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.cell.2020.02.052","article-title":"SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor","volume":"181","author":"Hoffmann","year":"2020","journal-title":"Cell"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41580-021-00418-x","article-title":"Mechanisms of SARS-CoV-2 entry into cells","volume":"23","author":"Jackson","year":"2022","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1007\/s12275-022-1502-8","article-title":"Coordinated regulation of interferon and inflammasome signaling pathways by SARS-CoV-2 proteins","volume":"60","author":"Kim","year":"2022","journal-title":"J. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Bello-Morales, R., Ripa, I., and Lopez-Guerrero, J.A. (2020). Extracellular Vesicles in Viral Spread and Antiviral Response. Viruses, 12.","DOI":"10.3390\/v12060623"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/1479-5876-9-86","article-title":"Body fluid derived exosomes as a novel template for clinical diagnostics","volume":"9","author":"Keller","year":"2011","journal-title":"J. Transl. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/s41586-020-2012-7","article-title":"A pneumonia outbreak associated with a new coronavirus of probable bat origin","volume":"579","author":"Zhou","year":"2020","journal-title":"Nature"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/s41579-020-00468-6","article-title":"Coronavirus biology and replication: Implications for SARS-CoV-2","volume":"19","author":"Kratzel","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Dutta, S., Zhu, Y., Han, Y., Almuntashiri, S., Wang, X., and Zhang, D. (2023). Long Noncoding RNA: A Novel Insight into the Pathogenesis of Acute Lung Injury. J. Clin. Med., 12.","DOI":"10.3390\/jcm12020604"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1038\/s41591-021-01630-0","article-title":"Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection","volume":"28","author":"Patone","year":"2022","journal-title":"Nat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ipinmoroti, A.O., and Matthews, Q.L. (2020). Extracellular Vesicles: Roles in Human Viral Infections, Immune-Diagnostic, and Therapeutic Applications. Pathogens, 9.","DOI":"10.3390\/pathogens9121056"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Aharon, A., Dangot, A., Kinaani, F., Zavaro, M., Bannon, L., Bar-Lev, T., Keren-Politansky, A., Avivi, I., and Jacob, G. (2023). Extracellular Vesicles of COVID-19 Patients Reflect Inflammation, Thrombogenicity, and Disease Severity. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24065918"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e12257","DOI":"10.1002\/jev2.12257","article-title":"Serum-derived extracellular vesicles: Novel biomarkers reflecting the disease severity of COVID-19 patients","volume":"11","author":"Tertel","year":"2022","journal-title":"J. Extracell. Vesicles"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1172\/JCI87316","article-title":"Extracellular vesicles: Masters of intercellular communication and potential clinical interventions","volume":"126","author":"Pitt","year":"2016","journal-title":"J. Clin. Investig."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1093\/femsre\/fuy042","article-title":"Extracellular membrane vesicles in the three domains of life and beyond","volume":"43","author":"Gill","year":"2019","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Han, Y., Jones, T.W., Dutta, S., Zhu, Y., Wang, X., Narayanan, S.P., Fagan, S.C., and Zhang, D. (2021). Overview and Update on Methods for Cargo Loading into Extracellular Vesicles. Processes, 9.","DOI":"10.3390\/pr9020356"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1038\/s41573-022-00410-w","article-title":"Therapeutically harnessing extracellular vesicles","volume":"21","author":"Cheng","year":"2022","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_33","unstructured":"Vesiclepedia (2026, May 11). A Community Compendium for Extracellular Vesicles and Particles. Available online: http:\/\/www.microvesicles.org\/."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e12404","DOI":"10.1002\/jev2.12404","article-title":"Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches","volume":"13","author":"Welsh","year":"2024","journal-title":"J. Extracell. Vesicles"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1684862","DOI":"10.1080\/20013078.2019.1684862","article-title":"Biological membranes in EV biogenesis, stability, uptake, and cargo transfer: An ISEV position paper arising from the ISEV membranes and EVs workshop","volume":"8","author":"Russell","year":"2019","journal-title":"J. Extracell. Vesicles"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00467-017-3816-z","article-title":"Exosomes and microvesicles in normal physiology, pathophysiology, and renal diseases","volume":"34","author":"Stahl","year":"2019","journal-title":"Pediatr. Nephrol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.chest.2017.06.026","article-title":"Extracellular Vesicles in Lung Disease","volume":"153","author":"Kubo","year":"2018","journal-title":"Chest"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"102121","DOI":"10.1016\/j.tranon.2024.102121","article-title":"A comprehensive review on recent advances in exosome isolation and characterization: Toward clinical applications","volume":"50","author":"Dilsiz","year":"2024","journal-title":"Transl. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"25","DOI":"10.21037\/amj-23-204","article-title":"Evaluating the feasibility of exosome technologies in COVID-19 treatment: Navigating the intersection of reality and fantasy perspectives","volume":"9","author":"Memon","year":"2024","journal-title":"AME Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zeng, H., Guo, S., Ren, X., Wu, Z., Liu, S., and Yao, X. (2023). Current Strategies for Exosome Cargo Loading and Targeting Delivery. Cells, 12.","DOI":"10.3390\/cells12101416"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2101557","DOI":"10.1002\/adhm.202101557","article-title":"RNA and Protein Delivery by Cell-Secreted and Bioengineered Extracellular Vesicles","volume":"11","author":"Wang","year":"2022","journal-title":"Adv. Healthc. Mater."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jconrel.2014.07.049","article-title":"Extracellular vesicles as drug delivery systems: Lessons from the liposome field","volume":"195","author":"Fens","year":"2014","journal-title":"J. Control Release"},{"key":"ref_43","first-page":"324","article-title":"Hit the bull\u2019s eye: Engineered extracellular vesicles for targeted therapy","volume":"64","author":"Cai","year":"2026","journal-title":"Bioact. Mater."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1128\/MMBR.00063-15","article-title":"Extracellular Vesicles Exploit Viral Entry Routes for Cargo Delivery","volume":"80","author":"Masoumi","year":"2016","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s12929-024-01063-0","article-title":"Hijacking host extracellular vesicle machinery by hepatotropic viruses: Current understandings and future prospects","volume":"31","author":"Chu","year":"2024","journal-title":"J. Biomed. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s40588-019-00123-6","article-title":"Extracellular Vesicles in Epstein-Barr Virus Pathogenesis","volume":"6","author":"Cone","year":"2019","journal-title":"Curr. Clin. Microbiol. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.semcdb.2017.03.005","article-title":"Herpesviruses hijack host exosomes for viral pathogenesis","volume":"67","author":"Sadeghipour","year":"2017","journal-title":"Semin. Cell Dev. Biol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1146\/annurev-cellbio-040621-032416","article-title":"A New Infectious Unit: Extracellular Vesicles Carrying Virus Populations","volume":"37","author":"Kerviel","year":"2021","journal-title":"Annu. Rev. Cell Dev. Biol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.fmre.2021.02.005","article-title":"Emerging roles of extracellular vesicles in mediating RNA virus infection","volume":"1","author":"Xia","year":"2021","journal-title":"Fundam. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ejim.2020.04.037","article-title":"The pivotal link between ACE2 deficiency and SARS-CoV-2 infection","volume":"76","author":"Verdecchia","year":"2020","journal-title":"Eur. J. Intern. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Hoffmann, M., Kleine-Weber, H., Kr\u00fcger, N., M\u00fcller, M., Drosten, C., and P\u00f6hlmann, S. (2020). The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. bioRxiv.","DOI":"10.1101\/2020.01.31.929042"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"109055","DOI":"10.1016\/j.celrep.2021.109055","article-title":"SARS-CoV-2 infection of primary human lung epithelium for COVID-19 modeling and drug discovery","volume":"35","author":"Mulay","year":"2021","journal-title":"Cell Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.cell.2022.01.001","article-title":"Receptor binding and complex structures of human ACE2 to spike RBD from omicron and delta SARS-CoV-2","volume":"185","author":"Han","year":"2022","journal-title":"Cell"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"100265","DOI":"10.1016\/j.mtbio.2022.100265","article-title":"Adsorption of SARS CoV-2 spike proteins on various functionalized surfaces correlates with the high transmissibility of Delta and Omicron variants","volume":"14","author":"Dobrynin","year":"2022","journal-title":"Mater. Today Bio"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e12050","DOI":"10.1002\/jev2.12050","article-title":"Extracellular vesicles containing ACE2 efficiently prevent infection by SARS-CoV-2 Spike protein-containing virus","volume":"10","author":"Cocozza","year":"2020","journal-title":"J. Extracell. Vesicles"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e2103471","DOI":"10.1002\/adma.202103471","article-title":"Engineering Extracellular Vesicles Enriched with Palmitoylated ACE2 as COVID-19 Therapy","volume":"33","author":"Xie","year":"2021","journal-title":"Adv. Mater."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3829","DOI":"10.1111\/febs.70433","article-title":"ADAMTS proteases in extracellular vesicles: Emerging mediators of extracellular matrix dynamics and disease progression","volume":"293","year":"2026","journal-title":"FEBS J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1083\/jcb.201211138","article-title":"Extracellular vesicles: Exosomes, microvesicles, and friends","volume":"200","author":"Raposo","year":"2013","journal-title":"J. Cell Biol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1038\/nrmicro.2017.60","article-title":"Viral effects on the content and function of extracellular vesicles","volume":"15","author":"Dittmer","year":"2017","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e12235","DOI":"10.1002\/jev2.12235","article-title":"Engineering extracellular vesicles by three-dimensional dynamic culture of human mesenchymal stem cells","volume":"11","author":"Yuan","year":"2022","journal-title":"J. Extracell. Vesicles"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e29782","DOI":"10.1002\/jmv.29782","article-title":"SARS-CoV-2 envelope protein-derived extracellular vesicles act as potential media for viral spillover","volume":"96","author":"Li","year":"2024","journal-title":"J. Med. Virol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e1026","DOI":"10.1002\/ctm2.1026","article-title":"Promising use of immune cell-derived exosomes in the treatment of SARS-CoV-2 infections","volume":"12","author":"Alahdal","year":"2022","journal-title":"Clin. Transl. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"108255","DOI":"10.1016\/j.intimp.2021.108255","article-title":"The triumvirate of NF-\u03baB, inflammation and cytokine storm in COVID-19","volume":"101","author":"Attiq","year":"2021","journal-title":"Int. Immunopharmacol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Kassem, D.H., and Kamal, M.M. (2020). Mesenchymal Stem Cells and Their Extracellular Vesicles: A Potential Game Changer for the COVID-19 Crisis. Front. Cell Dev. Biol., 8.","DOI":"10.3389\/fcell.2020.587866"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/JLB.3A0821-451RR","article-title":"Erythrocyte-derived extracellular vesicles aggravate inflammation by promoting the proinflammatory macrophage phenotype through TLR4-MyD88-NF-\u03baB-MAPK pathway","volume":"112","author":"Gao","year":"2022","journal-title":"J. Leukoc. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e0095122","DOI":"10.1128\/mbio.00951-22","article-title":"Circulatory Exosomes from COVID-19 Patients Trigger NLRP3 Inflammasome in Endothelial Cells","volume":"13","author":"Sur","year":"2022","journal-title":"mBio"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/j.cell.2010.01.040","article-title":"The inflammasomes","volume":"140","author":"Schroder","year":"2010","journal-title":"Cell"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1093\/qjmed\/hcad011","article-title":"NLRP3, the inflammasome and COVID-19 infection","volume":"116","author":"Yin","year":"2023","journal-title":"QJM Int. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1002\/jex2.37","article-title":"Serum extracellular vesicles profiling is associated with COVID-19 progression and immune responses","volume":"1","author":"Yim","year":"2022","journal-title":"J. Extracell. Biol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1038\/s41565-021-00931-2","article-title":"Extracellular vesicles as a next-generation drug delivery platform","volume":"16","author":"Herrmann","year":"2021","journal-title":"Nat. Nanotechnol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1080\/10717544.2020.1748758","article-title":"Prospects and challenges of extracellular vesicle-based drug delivery system: Considering cell source","volume":"27","author":"Meng","year":"2020","journal-title":"Drug Deliv."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/nbt.1807","article-title":"Delivery of siRNA to the mouse brain by systemic injection of targeted exosomes","volume":"29","author":"Seow","year":"2011","journal-title":"Nat. Biotechnol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Drescher, S., and van Hoogevest, P. (2020). The Phospholipid Research Center: Current Research in Phospholipids and Their Use in Drug Delivery. Pharmaceutics, 12.","DOI":"10.3390\/pharmaceutics12121235"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Al-Jipouri, A., Almurisi, S.H., Al-Japairai, K., Bakar, L.M., and Doolaanea, A.A. (2023). Liposomes or Extracellular Vesicles: A Comprehensive Comparison of Both Lipid Bilayer Vesicles for Pulmonary Drug Delivery. Polymers, 15.","DOI":"10.3390\/polym15020318"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1021\/acs.nanolett.1c00094","article-title":"Natural or Synthetic RNA Delivery: A Stoichiometric Comparison of Extracellular Vesicles and Synthetic Nanoparticles","volume":"21","author":"Murphy","year":"2021","journal-title":"Nano Lett."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1038\/ncb1596","article-title":"Exosome-mediated transfer of mRNAs and microRNAs is a novel mechanism of genetic exchange between cells","volume":"9","author":"Valadi","year":"2007","journal-title":"Nat. Cell Biol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"L977","DOI":"10.1152\/ajplung.00546.2018","article-title":"Extracellular vesicles in lung health, disease, and therapy","volume":"316","author":"McVey","year":"2019","journal-title":"Am. J. Physiol.-Lung Cell. Mol. Physiol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"104422","DOI":"10.1016\/j.meegid.2020.104422","article-title":"The role of extracellular vesicles in COVID-19 virus infection","volume":"85","author":"Hassanpour","year":"2020","journal-title":"Infect. Genet. Evol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1038\/s41467-021-27893-2","article-title":"Circulating ACE2-expressing extracellular vesicles block broad strains of SARS-CoV-2","volume":"13","author":"Hoffmann","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.tibtech.2024.08.007","article-title":"Engineering therapeutical extracellular vesicles for clinical translation","volume":"43","author":"Ma","year":"2025","journal-title":"Trends Biotechnol."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Yoshikawa, F.S.Y., Teixeira, F.M.E., Sato, M.N., and da Silva Oliveira, L. (2019). Delivery of microRNAs by Extracellular Vesicles in Viral Infections: Could the News be Packaged?. Cells, 8.","DOI":"10.3390\/cells8060611"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s12974-019-1587-0","article-title":"Exosomes derived from statin-modified bone marrow dendritic cells increase thymus-derived natural regulatory T cells in experimental autoimmune myasthenia gravis","volume":"16","author":"Zhang","year":"2019","journal-title":"J. Neuroinflamm."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"6440","DOI":"10.4049\/jimmunol.174.10.6440","article-title":"Exosomes derived from IL-10-treated dendritic cells can suppress inflammation and collagen-induced arthritis","volume":"174","author":"Kim","year":"2005","journal-title":"J. Immunol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"e13131","DOI":"10.1111\/sji.13131","article-title":"COVID-19 immunopathology with emphasis on Th17 response and cell-based immunomodulation therapy: Potential targets and challenges","volume":"95","author":"Pourgholaminejad","year":"2022","journal-title":"Scand. J. Immunol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.molimm.2021.02.008","article-title":"miRNA-467b inhibits Th17 differentiation by targeting eIF4E in experimental autoimmune encephalomyelitis","volume":"133","author":"Wu","year":"2021","journal-title":"Mol. Immunol."},{"key":"ref_86","first-page":"2897","article-title":"miR-146a regulates the function of Th17 cell differentiation to modulate cervical cancer cell growth and apoptosis through NF-\u03baB signaling by targeting TRAF6","volume":"41","author":"Li","year":"2019","journal-title":"Oncol. Rep."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1021\/acs.molpharmaceut.4c00233","article-title":"Treg-Derived Extracellular Vesicles: Roles in Diseases and Theranostics","volume":"21","author":"Wu","year":"2024","journal-title":"Mol. Pharm."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1007\/s13577-021-00547-7","article-title":"Bone marrow mesenchymal stem cell-derived exosomes induce the Th17\/Treg imbalance in immune thrombocytopenia through miR-146a-5p\/IRAK1 axis","volume":"34","author":"He","year":"2021","journal-title":"Hum. Cell"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1517\/14712598.2016.1170804","article-title":"Mesenchymal stem cell derived secretome and extracellular vesicles for acute lung injury and other inflammatory lung diseases","volume":"16","author":"Monsel","year":"2016","journal-title":"Expert. Opin. Biol. Ther."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1080\/14712598.2020.1689954","article-title":"Therapeutic potential of mesenchymal stem\/stromal cell-derived secretome and vesicles for lung injury and disease","volume":"20","author":"Liu","year":"2020","journal-title":"Expert. Opin. Biol. Ther."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1089\/scd.2020.0080","article-title":"Exosomes Derived from Bone Marrow Mesenchymal Stem Cells as Treatment for Severe COVID-19","volume":"29","author":"Sengupta","year":"2020","journal-title":"Stem Cells Dev."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1016\/j.chest.2023.06.024","article-title":"Bone Marrow Mesenchymal Stem Cell-Derived Extracellular Vesicle Infusion for the Treatment of Respiratory Failure from COVID-19: A Randomized, Placebo-Controlled Dosing Clinical Trial","volume":"164","author":"Lightner","year":"2023","journal-title":"CHEST"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5694\/mja2.50674","article-title":"COVID-19 acute respiratory distress syndrome (ARDS): Clinical features and differences from typical pre-COVID-19 ARDS","volume":"213","author":"Gibson","year":"2020","journal-title":"Med. J. Aust."},{"key":"ref_94","unstructured":"ClinicalTrials.gov (2026, May 25). Extracellular Vesicle Treatment for Acute Respiratory Distress Syndrome (ARDS) (EXTINGUISH ARDS), Available online: https:\/\/clinicaltrials.gov\/study\/NCT05354141."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"100278","DOI":"10.1016\/j.jlb.2024.100278","article-title":"Global requirements for manufacturing and validation of clinical grade extracellular vesicles","volume":"6","author":"Thakur","year":"2024","journal-title":"J. Liq. Biopsy"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Chianese, A., Zannella, C., Monti, A., De Filippis, A., Doti, N., Franci, G., and Galdiero, M. (2022). The Broad-Spectrum Antiviral Potential of the Amphibian Peptide AR-23. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23020883"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S0006-291X(03)00999-9","article-title":"A melittin-related peptide from the skin of the Japanese frog, Rana tagoi, with antimicrobial and cytolytic properties","volume":"306","author":"Conlon","year":"2003","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"27394","DOI":"10.1038\/srep27394","article-title":"Design of an \u03b1-helical antimicrobial peptide with improved cell-selective and potent anti-biofilm activity","volume":"6","author":"Zhang","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1182\/blood.2020007214","article-title":"Platelet gene expression and function in patients with COVID-19","volume":"136","author":"Manne","year":"2020","journal-title":"Blood"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1038\/s41577-021-00536-9","article-title":"Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19","volume":"21","author":"Bonaventura","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Ebeyer-Masotta, M., Eichhorn, T., Weiss, R., Laukova, L., and Weber, V. (2022). Activated Platelets and Platelet-Derived Extracellular Vesicles Mediate COVID-19-Associated Immunothrombosis. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.914891"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.5415\/apallergy.2020.10.e25","article-title":"Importance of microbial extracellular vesicle in the pathogenesis of asthma and chronic obstructive pulmonary disease and its diagnostic potential","volume":"10","author":"Kim","year":"2020","journal-title":"Asia Pac. Allergy"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1007\/s00253-023-12468-6","article-title":"Extracellular vesicles in COVID-19 prognosis, treatment, and vaccination: An update","volume":"107","author":"Carrero","year":"2023","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Cappellano, G., Raineri, D., Rolla, R., Giordano, M., Puricelli, C., Vilardo, B., Manfredi, M., Cantaluppi, V., Sainaghi, P.P., and Castello, L. (2021). Circulating Platelet-Derived Extracellular Vesicles Are a Hallmark of SARS-CoV-2 Infection. Cells, 10.","DOI":"10.3390\/cells10010085"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Rojas, K., Verdugo-Molinares, M.G., Ochoa-Ruiz, A.G., Canales, A., Reza-Zaldivar, E.E., Lim\u00f3n-Rojas, A., and Vallejo-Cardona, A.A. (2022). Approximations to Diagnosis and Therapy of COVID-19 in Nervous Systems Using Extracellular Vesicles. Pathogens, 11.","DOI":"10.3390\/pathogens11121501"},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Kudryavtsev, I., Kalinina, O., Bezrukikh, V., Melnik, O., and Golovkin, A. (2021). The Significance of Phenotyping and Quantification of Plasma Extracellular Vesicles Levels Using High-Sensitivity Flow Cytometry during COVID-19 Treatment. Viruses, 13.","DOI":"10.3390\/v13050767"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s41232-022-00243-5","article-title":"Next-generation proteomics of serum extracellular vesicles combined with single-cell RNA sequencing identifies MACROH2A1 associated with refractory COVID-19","volume":"42","author":"Kawasaki","year":"2022","journal-title":"Inflamm. Regen."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.cmet.2020.06.016","article-title":"Omics-Driven Systems Interrogation of Metabolic Dysregulation in COVID-19 Pathogenesis","volume":"32","author":"Song","year":"2020","journal-title":"Cell Metab."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"103369","DOI":"10.1016\/j.ebiom.2021.103369","article-title":"Circulating extracellular vesicles are endowed with enhanced procoagulant activity in SARS-CoV-2 infection","volume":"67","author":"Balbi","year":"2021","journal-title":"eBioMedicine"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"172","DOI":"10.20517\/evcna.2022.19","article-title":"Exploring extracellular vesicles as mediators of clinical disease and vehicles for viral therapeutics: Insights from the COVID-19 pandemic","volume":"3","author":"Craddock","year":"2022","journal-title":"Extracell. Vesicles Circ. Nucleic Acids"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1593755","DOI":"10.1080\/20013078.2019.1593755","article-title":"Clinical requirements for extracellular vesicle assays","volume":"8","author":"Ayers","year":"2019","journal-title":"J. Extracell. Vesicles"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e12037","DOI":"10.1002\/jev2.12037","article-title":"Rigor and standardization of extracellular vesicle research: Paving the road towards robustness","volume":"10","author":"Nieuwland","year":"2020","journal-title":"J. Extracell. Vesicles"},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Barberis, E., Vanella, V.V., Falasca, M., Caneapero, V., Cappellano, G., Raineri, D., Ghirimoldi, M., De Giorgis, V., Puricelli, C., and Vaschetto, R. (2021). Circulating Exosomes Are Strongly Involved in SARS-CoV-2 Infection. Front. Mol. Biosci., 8.","DOI":"10.3389\/fmolb.2021.632290"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1016\/j.cell.2020.08.021","article-title":"Emerging Pandemic Diseases: How We Got to COVID-19","volume":"182","author":"Morens","year":"2020","journal-title":"Cell"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"6638","DOI":"10.1038\/s41598-021-85875-2","article-title":"Multiwave pandemic dynamics explained: How to tame the next wave of infectious diseases","volume":"11","author":"Cacciapaglia","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_116","unstructured":"(2026, May 31). World Health Leaders Warn of Pandemic 20 Times Worse than COVID. Available online: https:\/\/thehill.com\/changing-america\/well-being\/prevention-cures\/4424600-world-health-leaders-warn-of-pandemic-20-times-worse-than-covid\/."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"e012026","DOI":"10.1136\/bmjgh-2023-012026","article-title":"Historical trends demonstrate a pattern of increasingly frequent and severe spillover events of high-consequence zoonotic viruses","volume":"8","author":"Meadows","year":"2023","journal-title":"BMJ Glob. Health"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1093\/ilar\/ilx026","article-title":"Are RNA Viruses Candidate Agents for the Next Global Pandemic? A Review","volume":"58","author":"Jacome","year":"2017","journal-title":"ILAR J."},{"key":"ref_119","unstructured":"U.S. Government Accountability Office (2026, May 16). In the Next Pandemic Antiviral Drugs Could Be Key, but Are They Ready?, Available online: https:\/\/www.gao.gov\/blog\/next-pandemic-antiviral-drugs-could-be-key-are-they-ready."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Cosentino, G., Marougka, K., Desquesnes, A., Welti, N., Sitterlin, D., Gault, E., and Rameix-Welti, M.A. (2022). Respiratory syncytial virus ribonucleoproteins hijack microtubule Rab11 dependent transport for intracellular trafficking. PLoS Pathog., 18.","DOI":"10.1371\/journal.ppat.1010619"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"4872","DOI":"10.1016\/j.jmb.2013.09.015","article-title":"Paramyxovirus activation and inhibition of innate immune responses","volume":"425","author":"Parks","year":"2013","journal-title":"J. Mol. Biol."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Sanjuan, R. (2012). From molecular genetics to phylodynamics: Evolutionary relevance of mutation rates across viruses. PLoS Pathog., 8.","DOI":"10.1371\/journal.ppat.1002685"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1038\/nature06536","article-title":"Global trends in emerging infectious diseases","volume":"451","author":"Jones","year":"2008","journal-title":"Nature"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.arcmed.2020.10.012","article-title":"COVID-19 and Flu Pandemics Follow a Pattern: A Possible Cross-immunity in the Pandemic Origin and Graver Disease in Farther Regions","volume":"52","author":"Bolourian","year":"2021","journal-title":"Arch. Med. Res."},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Borowiec, B.M., Angelova Volponi, A., Mozdziak, P., Kempisty, B., and Dyszkiewicz-Konwinska, M. (2021). Small Extracellular Vesicles and COVID19\u2014Using the \u201cTrojan Horse\u201d to Tackle the Giant. Cells, 10.","DOI":"10.3390\/cells10123383"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1038\/s41564-018-0296-2","article-title":"Tracking virus outbreaks in the twenty-first century","volume":"4","author":"Grubaugh","year":"2019","journal-title":"Nat. Microbiol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.omtm.2022.01.015","article-title":"Engineered extracellular vesicles directed to the spike protein inhibit SARS-CoV-2","volume":"24","author":"Scott","year":"2022","journal-title":"Mol. Ther. Methods Clin. Dev."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"e2301010","DOI":"10.1002\/adhm.202301010","article-title":"Clinical Translation of Extracellular Vesicles","volume":"12","author":"Ghodasara","year":"2023","journal-title":"Adv. Healthc. Mater."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"114515","DOI":"10.1016\/j.jconrel.2025.114515","article-title":"A single extracellular vesicle-based platform supporting both RBD protein and mRNA vaccination against SARS-CoV-2","volume":"390","author":"Chung","year":"2026","journal-title":"J. Control. Release"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"113542","DOI":"10.1016\/j.isci.2025.113542","article-title":"Extracellular vesicles: Antiviral functions and applications in therapeutics and vaccines","volume":"28","author":"Gao","year":"2025","journal-title":"iScience"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Gao, Q., Zhan, Y., Zhang, J., Sun, D., Xiang, H., Bao, C., Gao, Q., Zhang, M., Wang, J., and Mao, L. (2025). The diagnostic potential of extracellular vesicles in virus-related diseases. Front. Cell Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1641405"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"e21913","DOI":"10.1002\/advs.202521913","article-title":"Beyond Extracellular Vesicle (EV) Hype: Practical Solutions and Remaining Hurdles in EV Research, Manufacturing, and Clinical Translation","volume":"13","author":"Lundy","year":"2026","journal-title":"Adv. Sci."},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Martins, S.T., and Alves, L.R. (2020). Extracellular Vesicles in Viral Infections: Two Sides of the Same Coin?. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.593170"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1609206","DOI":"10.1080\/20013078.2019.1609206","article-title":"Defining mesenchymal stromal cell (MSC)-derived small extracellular vesicles for therapeutic applications","volume":"8","author":"Witwer","year":"2019","journal-title":"J. Extracell. Vesicles"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.jconrel.2020.10.020","article-title":"Challenges in the development and establishment of exosome-based drug delivery systems","volume":"329","author":"Wang","year":"2021","journal-title":"J. Control. Release"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s40005-024-00699-2","article-title":"Extracellular vesicles as drug delivery systems in therapeutics: Current strategies and future challenges","volume":"54","author":"Lu","year":"2024","journal-title":"J. Pharm. Investig."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"30087","DOI":"10.3402\/jev.v4.30087","article-title":"Applying extracellular vesicles based therapeutics in clinical trials\u2014An ISEV position paper","volume":"4","author":"Lener","year":"2015","journal-title":"J. Extracell. Vesicles"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"e13904","DOI":"10.1111\/cts.13904","article-title":"Regulation of exosomes as biologic medicines: Regulatory challenges faced in exosome development and manufacturing processes","volume":"17","author":"Wang","year":"2024","journal-title":"Clin. Transl. Sci."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"100029","DOI":"10.1016\/j.vesic.2023.100029","article-title":"Guidelines for clinical translation and commercialization of extracellular vesicles and exosomes based therapeutics","volume":"2","author":"Cheng","year":"2023","journal-title":"Extracell. Vesicle"}],"container-title":["Current Issues in Molecular Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/9\/924\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:25:51Z","timestamp":1789187151000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1467-3045\/48\/9\/924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":139,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["cimb48090924"],"URL":"https:\/\/doi.org\/10.3390\/cimb48090924","relation":{},"ISSN":["1467-3045"],"issn-type":[{"value":"1467-3045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}