{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:32:38Z","timestamp":1793039558784,"version":"4.5.0"},"reference-count":248,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004731","name":"Zhejiang Provincial Natural Science Foundation of China","doi-asserted-by":"publisher","award":["LQ24H160003"],"award-info":[{"award-number":["LQ24H160003"]}],"id":[{"id":"10.13039\/501100004731","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Medical Scientific Research Foundation of Zhejiang Province","award":["2023KY299"],"award-info":[{"award-number":["2023KY299"]}]},{"name":"Medical Scientific Research Foundation of Zhejiang Province","award":["2024KY351"],"award-info":[{"award-number":["2024KY351"]}]},{"DOI":"10.13039\/100007834","name":"Ningbo Natural Science Foundation","doi-asserted-by":"publisher","award":["2023J365"],"award-info":[{"award-number":["2023J365"]}],"id":[{"id":"10.13039\/100007834","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Young Innovative Talent Project of Yongjiang Talent Introduction Programme of Ningbo Municipal Government","award":["2021A-012-G"],"award-info":[{"award-number":["2021A-012-G"]}]},{"name":"Bei\u2019An Talent Programme of Jiangbei District of Ningbo","award":["2023RC004"],"award-info":[{"award-number":["2023RC004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Alzheimer\u2019s disease (AD) is a progressive neurodegenerative disorder characterized by the accumulation of amyloid-\u03b2 (A\u03b2) plaques, neurofibrillary tau tangles, chronic neuroinflammation, and synaptic loss, leading to cognitive decline. Extracellular vesicles (EVs)\u2014lipid bilayer nanoparticles secreted by nearly all cell types\u2014have emerged as critical mediators of intercellular communication, playing a complex dual role in both the pathogenesis and potential treatment of AD. This review generally delineates two opposite roles of EVs in pathogenesis and potential treatment of AD. On one hand, EVs derived from neurons, astrocytes, microglia and oligodendrocytes can propagate toxic proteins (A\u03b2, tau) and inflammatory signals, thereby accelerating disease progression. On the other hand, EVs\u2014especially those from mesenchymal stem cells (MSCs)\u2014exert neuroprotective effects by facilitating toxic protein clearance, modulating immune responses, preserving synaptic integrity, and alleviating oxidative stress. The cargo-carrying function of EVs gives them considerable diagnostic value. The associated cargos such as proteins and microRNAs (miRNAs) in the EVs may serve as minimally invasive biomarkers for early detection and monitoring of AD. Therapeutically, engineered EVs, including those incorporating CRISPR\/Cas9-based genetic modification, are being developed as sophisticated delivery platforms for targeting core AD pathologies. Furthermore, this review highlights emerging technologies such as microfluidic chips and focused ultrasound (FUS), discussing their potential to enhance the translational prospects of EV-based early diagnostic and treatment for AD.<\/jats:p>","DOI":"10.3390\/pharmaceutics18010070","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:28:57Z","timestamp":1767626937000},"page":"70","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Extracellular Vesicles in Alzheimer\u2019s Disease: Dual Roles in Pathogenesis, Promising Avenues for Diagnosis and Therapy"],"prefix":"10.3390","volume":"18","author":[{"given":"Feng","family":"Li","sequence":"first","affiliation":[{"name":"College of Biological & Environmental Sciences, Zhejiang Wanli University, Ningbo 315000, China"},{"name":"Innovation Center for Diagnosis and Treatment of Neurological Disease, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"},{"name":"Lab of Nanopharmacology Research for Neurodegeneration, Department of Research and Development of Science and Technology, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Innovation Center for Diagnosis and Treatment of Neurological Disease, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"},{"name":"Lab of Nanopharmacology Research for Neurodegeneration, Department of Research and Development of Science and Technology, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Feng","sequence":"additional","affiliation":[{"name":"Innovation Center for Diagnosis and Treatment of Neurological Disease, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"},{"name":"Lab of Dementia and Neurorehabilitation Research, Department of Research Development of Science and Technology, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-3582","authenticated-orcid":false,"given":"Yihong","family":"Li","sequence":"additional","affiliation":[{"name":"College of Biological & Environmental Sciences, Zhejiang Wanli University, Ningbo 315000, China"},{"name":"Innovation Center for Diagnosis and Treatment of Neurological Disease, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"},{"name":"Lab of Nanopharmacology Research for Neurodegeneration, Department of Research and Development of Science and Technology, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5282-4843","authenticated-orcid":false,"given":"Huadong","family":"Fan","sequence":"additional","affiliation":[{"name":"College of Biological & Environmental Sciences, Zhejiang Wanli University, Ningbo 315000, China"},{"name":"Innovation Center for Diagnosis and Treatment of Neurological Disease, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"},{"name":"Lab of Dementia and Neurorehabilitation Research, Department of Research Development of Science and Technology, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3708","DOI":"10.1002\/alz.13809","article-title":"2024 Alzheimer\u2019s disease facts and figures","volume":"20","author":"Better","year":"2024","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3233\/JAD-220239","article-title":"Costs of Dementia in Low- and Middle-Income Countries: A Systematic Review","volume":"91","author":"Malaha","year":"2023","journal-title":"J. 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