bims-engexo Biomed News
on Engineered exosomes
Issue of 2026–05–17
fifteen papers selected by
Ravindran Jaganathan, Universiti Kuala Lumpur



  1. Mol Neurobiol. 2026 May 13. pii: 626. [Epub ahead of print]63(1):
      Parkinson's disease is a progressive neurodegenerative disorder marked by dopaminergic neuron loss in the substantia nigra, pathological α-synuclein aggregation, and persistent neuroinflammation. Current therapies mainly offer symptomatic relief but do not halt or reverse disease progression, largely because of the restrictive blood-brain barrier. Exosomes, naturally occurring nanoscale vesicles, possess key attributes such as biocompatibility, low immunogenicity, and the capacity to cross the blood-brain barrier. In Parkinson's disease, exosomes have a dual role: they propagate α-syn pathology and amplify inflammatory signaling, accelerating disease progression; conversely, they can be engineered as carriers of neurotrophic factors, microRNAs, or small-molecule drugs, conferring neuroprotective and anti-inflammatory benefits. This review examines current strategies for exosome engineering, with emphasis on surface modification and optimized cargo loading. However, clinical translation remains hindered by suboptimal delivery efficiency, limited brain accumulation, potential immunogenicity, exosome heterogeneity, and regulatory barriers. Future research should prioritize high-affinity targeting ligands, multimodal delivery platforms, deeper insights into blood-brain barrier translocation, and integration with regenerative medicine approaches. These advancements are essential for standardized large-scale production and personalized therapies, ultimately advancing precision medicine in Parkinson's disease.
    Keywords:  Blood–brain barrier; Engineered exosomes; Parkinson’s disease; Surface modification; Targeted drug delivery
    DOI:  https://doi.org/10.1007/s12035-026-05898-6
  2. Front Immunol. 2026 ;17 1820504
      Knee osteoarthritis (KOA) is a common age-related degenerative joint disease. Currently, there is a lack of effective treatments capable of altering its progression. Exosomes, as key mediators of intercellular communication, possess innate biocompatibility, low immunogenicity, and favorable barrier-penetrating capabilities, demonstrating potential in modulating the joint microenvironment. However, natural exosomes face challenges such as poor targeting specificity, limited drug-loading capacity, and a short half-life. To address these limitations, engineered exosomes have been developed through strategies including surface modification, drug-loading optimization, and integration with biomaterials, significantly enhancing their therapeutic efficacy in preclinical models. This review summarizes recent advances in the application of engineered exosomes for KOA treatment, with a focus on elucidating their molecular mechanisms in inhibiting inflammation, regulating chondrocyte function, maintaining extracellular matrix (ECM) homeostasis, modulating subchondral bone remodeling, and influencing pain pathways. Although preclinical studies have demonstrated promising therapeutic outcomes, the clinical translation of engineered exosomes still faces challenges, including standardized production, safety evaluation, optimization of targeting efficiency, and validation in large animal models. While Phase I safety data are available, the field currently lacks Phase II efficacy data or disease-modifying proof. Therefore, engineered exosomes represent a promising preclinical candidate requiring further validation through Phase II/III trials. Future research should focus on deepening mechanistic understanding, standardizing production processes, and conducting rigorous clinical trials to establish engineered exosomes as a viable therapeutic option for KOA.
    Keywords:  biomaterials; cartilage repair; engineered exosomes; joint microenvironment; knee osteoarthritis; regenerative medicine; targeted therapy
    DOI:  https://doi.org/10.3389/fimmu.2026.1820504
  3. Ann Surg Oncol. 2026 May 12.
       BACKGROUND: Radiation therapy is a common treatment for patients with esophageal cancer (EC). Local recurrence after radiotherapy is one of the main reasons for treatment failure. Exosomal microRNA (miRNA) is associated with the initiation and progression of EC. However, the efficacy of exosomal miRNA in sensitivity to radiotherapy in EC remains unknown.
    MATERIALS AND METHODS: This study exploited engineered exosomes to deliver miR-423-5p mimic oligonucleotide simultaneously to EC cells. We cocultured EC cell lines by constructing engineered exosomes overexpressing miR-423-5p. Radiotherapy was given concomitantly. The CCK8 and flow cytometric assays were used to detect proliferation and apoptosis, respectively. The dual-luciferase reporter was used to verify MAP7D1 as a putative target of miR-423-5p. The expression levels of MAP7D1 in patients with EC were analyzed to study the clinical value of this parameter.
    RESULTS: The results demonstrated that the upregulation of miR-423-5p reduced tumor proliferation (P < 0.01) and increased apoptosis (P < 0.01) during radiotherapy. Notably, cotreatment with Exo-miR-423-5p enhanced both early apoptotic and necrotic cell populations, suggesting potential immunogenic cell death. The luciferase reporter demonstrated that miR-423-5p targeted MAP7D1 3'UTR. Moreover, MAP7D1 expression was lower in EC cancer tissues than adjacent tissues (P < 0.001). In vivo, xenograft studies in nude mice revealed that systemic administration of Exo-miR-423-5p combined with radiation significantly inhibited tumor growth, improved survival, and exhibited favorable biodistribution with minimal toxicity.
    CONCLUSIONS: The strategy of delivering miR-423-5p via exosomes foreshadows a potential approach for improving EC radiotherapy sensitivity and, consequently, the efficacy of cancer treatment.
    Keywords:  Esophageal cancer; Exosome; Radiation sensitivity; miR-423-5p
    DOI:  https://doi.org/10.1245/s10434-026-19692-0
  4. Int Rev Immunol. 2026 May 09. 1-19
      Dysregulated B lymphocyte activation plays a pivotal role in the pathogenesis of systemic lupus erythematosus (SLE), making it a promising target for therapeutic intervention. Chimeric antigen receptor T cell (CAR-T) therapy, specifically targeting CD19-positive B cells, has shown potential in selectively eliminating aberrant B cells, offering a path toward sustained remission and even complete eradication of SLE. However, the broad immunosuppressive effects and cytotoxicity associated with CAR-T therapy pose significant challenges to its application in autoimmune disease treatment. Recent advances in extracellular vesicle biology, particularly exosomes, have highlighted their potential as a cell-free therapeutic platform due to their superior biocompatibility, plasticity, and ability to modulate immune responses. CAR-T-derived or engineered exosomes represent a potential cell-free alternative to reduce cellular dose and toxicity while preserving efficacy in SLE. This review provides a comprehensive analysis of the current landscape of CAR-T cell therapy in autoimmune diseases, with a focus on its safety, effectiveness, and potential in treating SLE. Furthermore, it explores the emerging role of exosomes as a promising adjunct to traditional CAR-T therapy, offering novel perspectives and therapeutic strategies for SLE management.
    Keywords:  Autoimmune diseases; CAR-t; CD19; exosomes; systemic lupus erythematosus
    DOI:  https://doi.org/10.1080/08830185.2026.2669734
  5. Int J Nanomedicine. 2026 ;21 601425
      The convergence of nanomedicine and regenerative biology offers new paradigms for tissue repair. The reconstruction of critical-sized bone defects, particularly within the anatomically intricate and physiologically distinct landscape of the craniomaxillofacial (CMF) region, represents a formidable frontier in regenerative medicine. Bone regeneration is not a singular biological event but a temporally orchestrated symphony, necessitating the precise, sequential coordination of immunomodulation, angiogenesis, and osteogenesis. While mesenchymal stem cell-derived extracellular vesicles (MSC-Exos) have emerged as a paradigm-shifting cell-free therapeutic - circumventing the engraftment instability, tumorigenicity, and immunogenicity limitations of live cell therapies-their clinical translation remains hindered by a fundamental kinetic mismatch: the delivery of a static, unmodulated bolus to a highly dynamic wound microenvironment. Current therapeutic strategies predominantly rely on simple injection or bulk incorporation of MSC-Exos into scaffolds. These static delivery paradigms fail to recapitulate the physiological rhythm of healing, often creating a kinetic mismatch between a single therapeutic cargo and the host's changing needs. This review bridges a critical synthesis gap by proposing a novel "spatiotemporal programming" framework for bone regeneration. We systematically integrate cargo engineering strategies (eg, hypoxic/inflammatory priming, genetic modification) with smart biomaterial design (eg, stimuli-responsive hydrogels, core-shell scaffolds) to achieve sequential, phase-specific delivery. By aligning exosomal bioactivity with the intrinsic immuno-angiogenic-osteogenic cascade and emphasizing cargo tailoring for craniomaxillofacial specificity, this work provides a translational roadmap for next-generation, precision-guided skeletal reconstruction.
    Keywords:  bone regeneration; exosomes; mesenchymal stem cell; nanomedicine; spatiotemporal delivery
    DOI:  https://doi.org/10.2147/IJN.S601425
  6. Int J Pharm. 2026 May 07. pii: S0378-5173(26)00294-2. [Epub ahead of print]698 126846
      Exosomes are endogenous extracellular vesicles with exceptional biocompatibility and intrinsic targeting potential, yet their clinical translation is limited by functional heterogeneity, insufficient controllability, and lack of spatiotemporal precision. While numerous engineering strategies have been developed, most remain confined to single-function enhancement and fail to achieve coordinated, programmable therapeutic control. In this Review, we propose the concept of "smart exosomes" as a next-generation paradigm for exosome engineering, defined by multi-stimuli responsiveness, Boolean logic-gated signal processing, and multimodal theranostic integration. We summarize exosomal biomarkers across animal-, plant-, and microbial-derived vesicles and highlight their evolving roles from passive identifiers to active structural and functional interfaces for intelligent design. Natural exosome organotropism and surface molecular fingerprints are discussed as a biological foundation for precision targeting. We further review the major exosome engineering strategies, including genetic modification, chemical conjugation, physical manipulation, and exosome-nanocarrier hybridization, which together constitute a versatile engineering toolbox. A central focus is the integration of endogenous and exogenous cues-such as pH, redox status, enzymatic activity, and external physical stimuli-into logic-gated exosome systems capable of multi-input sensing and conditional activation. Importantly, we explicitly differentiate experimentally validated logic-gated exosome systems from hypothetical or extrapolated designs, and we discuss the key technological barriers to achieving true multi-input Boolean logic execution in vivo. Such designs enable programmable cargo release, imaging feedback, and precisely controlled therapeutic action. Finally, we discuss key translational challenges and outline future directions toward AI-assisted design, plant-derived exosome platforms, and cooperative multi-stimulus response systems. Collectively, this Review establishes a conceptual framework for programmable exosome-based precision theranostics.
    Keywords:  Logic-gated drug delivery; Multimodal exosome engineering; Precision theranostics; Smart exosomes; Stimuli-responsive exosomes
    DOI:  https://doi.org/10.1016/j.ijpharm.2026.126846
  7. Int J Pharm. 2026 May 07. pii: S0378-5173(26)00414-X. [Epub ahead of print]698 126966
      Exosomes are nanoscale extracellular vesicles released by various cell types and have gained significant attention for their ability to transport diverse bioactive molecules. Their inherent stability, tumor-targeting capability, biocompatibility, and low immunogenicity make them promising candidates for drug delivery in cancer therapy. Despite these advantages, a gap remains between their biological understanding and optimal clinical application. Exosomes play a dual role in cancer as both therapeutic delivery systems and mediators of disease progression. Their phospholipid membrane enhances targeted drug delivery, while exosome-associated biomarkers offer new opportunities for cancer diagnosis. This review provides a comprehensive overview of exosome biogenesis, isolation methods, cargo loading strategies, roles in cancer progression, and applications in drug delivery and theranostics. It also highlights the advantages, limitations, and current clinical advancements of exosome-based systems. Overall, exosomes represent a cutting-edge platform with the potential to transform future cancer diagnosis and treatment.
    Keywords:  Cancer nanomedicine; Exosomes; Immunotherapy; Nanocarriers; Personalized medicine; Targeted drug delivery
    DOI:  https://doi.org/10.1016/j.ijpharm.2026.126966
  8. Biomater Adv. 2026 May 08. pii: S2772-9508(26)00237-2. [Epub ahead of print]186 214939
      Exosomes have emerged as an ideal therapeutic vehicle owing to their inherent biocompatibility, low immunogenicity, and capacity for efficient biomolecule delivery. Nevertheless, inherent limitations, such as poor stability, inadequate targeting specificity, and limited therapeutic mechanisms, significantly confine their clinical application. This study innovatively developed a multifunctional nanocomposite system (EXO@Cu-Cys@ZIF)PDA/Ab based on zeolitic imidazolate framework-8 (ZIF-8). This system achieved high-efficiency exosome encapsulation and pH-responsive controlled release through microporous confinement effects and markedly improved circulatory stability via polydopamine (PDA) coating. Organ-targeting capability was also enhanced through specific antibody modifications. By integrating the reactive oxygen species (ROS)-scavenging ability of Cu-Cys nanozymes with the gene regulatory function of exosomes, this platform can synergistically restore redox homeostasis, suppress key signaling pathways involved in fibrosis, and modulate lipid metabolism, thereby effectively reversing fibrosis in the lungs, liver, and kidneys. The system also addressed the bottleneck of traditional clinical application of exosomes through the three-dimensional synergy mechanism of "exosome protection and delivery system-nanozyme activity regulation-organ targeting module". The system also provides a customized and universal solution for the simultaneous treatment of multiorgan-organ diseases.
    Keywords:  Cascade reaction; Exosome; Nanozyme; Oxidation resistance; Urine-derived stem cells
    DOI:  https://doi.org/10.1016/j.bioadv.2026.214939
  9. Cell Rep Med. 2026 May 14. pii: S2666-3791(26)00236-3. [Epub ahead of print] 102819
      A critical challenge in sepsis treatment lies in its complex immune microenvironment, characterized by concurrent hyperinflammation and immunosuppression. This imbalance is jointly driven by dysregulated neutrophil programmed death and abnormal activation of the PD-1/PD-L1 immune checkpoint. Therefore, precisely modulating neutrophil fate and blocking this immune checkpoint are highly promising therapeutic strategies. We engineered an artificial exosome nano-decoy (AT@NV-PD1) that homes to senescent-like neutrophils. It comprises a pH-responsive bovine serum albumin core carrying AT7519, a cyclin-dependent kinase inhibitor, cloaked with macrophage membrane presenting PD-1. After intravenous delivery, PD-1 selectively binds PD-L1 on target neutrophils. In the mildly acidic microenvironment, AT7519 release triggers timely neutrophil apoptosis, curbing excessive inflammation. Concurrently, the nano-decoy neutralizes bacterial toxins and inflammatory cytokines. By engaging PD-L1, AT@NV-PD1 also alleviates T cell exhaustion, reduces immunosuppression, and promotes immune homeostasis. In conclusion, AT@NV-PD1 represents a sepsis therapy by precisely regulating neutrophil fate and rebuilding immune balance.
    Keywords:  T-cell exhaustion; apoptosis; immune homeostasis; neutrophils; sepsis
    DOI:  https://doi.org/10.1016/j.xcrm.2026.102819
  10. Br J Pharmacol. 2026 May 14.
       BACKGROUND AND PURPOSE: Exploring the targeted regulatory effect of isorhynchophylline on lipopolysaccharide (LPS)-induced acute lung injury (ALI) by constructing a drug delivery system of GEF-modified exosomes derived from M2 macrophages (M2-Exos) loaded with isorhynchophylline (GEF-M2-Exos-IRN; GMI).
    EXPERIMENTAL APPROACH: GMI was constructed using an ultrasonic method with M2-Exos and isorhynchophylline. Targeting GMI was traced using immunofluorescence of mouse lung tissue frozen sections and BEAS-2B/A549 cells. Haematoxylin and eosin staining was used to detect pathological changes and Terminal deoxynucleotidyl transferase dUTP Nick-End Labelling (TUNEL) was employed to detect cell apoptosis. Expression levels of α-SMA, iNOS and Arg1 were detected via immunohistochemistry and fluorescence. GMI intervention in acute lung injury were analysed by transcriptome sequencing and key differential genes were verified by quantitative reverse transcription polymerase chain reaction (RT-qPCR).
    KEY RESULTS: GMI drug lung targeting delivery system was successfully constructed. GMI reduced the percentage of apoptotic cells, down-regulate the expression of α-SMA, inhibit M1 phenotype and activated M2 phenotype. Transcriptome sequencing showed that LPS promoted Th17 differentiation through the NF-κB/MAPK/JAK-STAT pathway, causing an IL-6/TNF-α inflammatory storm, inducing metabolic-oxidative stress aggravating the injury. GMI reversed the injury inhibiting Th17/CXCL axis, activating Treg/TGF-β axis, restoring glycolysis/cholesterol metabolism, epigenetically regulating SOCS3 and promoting tissue barrier reconstruction. Gene interaction network identified Spib-Pou2f1-Aicda/Tnfrsf4 as the core hub, mediating the immune-inflammatory reaction. The key differential genes were consistent with the sequencing results after RT-qPCR verification.
    CONCLUSIONS AND IMPLICATIONS: GMI alleviates LPS-induced acute lung injury through a multi-factorial network of 'inflammation-metabolism-epigenetics', providing a new strategy for lung-targeted anti-inflammatory treatment.
    Keywords:  Isorhynchophylline; M2 macrophage exosomes; acute lung injury; nanoparticulate drug delivery system
    DOI:  https://doi.org/10.1111/bph.70403
  11. Adv Biol (Weinh). 2026 May;10(5): e70127
      Breast cancer is a heterogeneous disease and is characterized by desmoplastic tumors. Conventional nanocarriers are unable to accumulate in the tumor microenvironment owing to their inability to extravasate through tumor vessels and the high density of the desmoplastic breast tumor. In addition, the exogenous nature of nanocarriers makes them susceptible to recognition by the reticuloendothelial system and therefore leads to short systemic half-life. Exosomes, also known as the body's natural nanocarriers, have an inherent ability to carry nucleic acids. Due to their endogenous nature, they can bypass the macrophages and thus, show prolonged systemic half-life. Exosomes isolated from sources such as macrophages, neutrophils, and mesenchymal stem cells have demonstrated the ability to penetrate and accumulate in breast tumors. Thus, in the present review article, we have highlighted advantages and challenges associated with the delivery of RNAi-loaded exosomes for the precision therapy of breast cancer. Additionally, it reviews various oncogenic targets and the ability of RNAi-loaded exosomes to modulate them. We have also mentioned the common bottlenecks and challenges faced by formulation scientists in the clinical translation of RNAi-loaded exosomes.
    Keywords:  RNAi; breast cancer; clinical bottlenecks; exosomes; molecular targets; precision therapy
    DOI:  https://doi.org/10.1002/adbi.70127
  12. Int J Nanomedicine. 2026 ;21 598699
      Chronic pain management faces significant limitations due to adverse effects and insufficient long-term relief from existing therapies. Extracellular vesicles (EVs) are lipid bilayer-enclosed particles naturally carrying proteins, nucleic acids, and metabolites. Recently, EVs have emerged as a potential alternative approach. This review examines EVs from mesenchymal stem cells, neural cells, macrophages, and gut microbiota. EV activity is then assessed across the three major pain types defined by the ICD‑11: nociceptive pain, neuropathic pain, and nociplastic pain. We elucidate how source-specific EVs dynamically regulate different kinds of pain through multi-modal mechanisms, including neural signal transduction, neuroimmune axis coordination, structural neural repair, and metabolic network reprogramming. Furthermore, we discuss how these inherent therapeutic properties can be augmented through engineering approaches such as surface modification and cargo encapsulation, which enhance targeting and payload delivery. By integrating mechanistic insights into source‑specific EV functions with emerging engineering strategies, this review may provide a rational framework for developing next‑generation EV‑based analgesics. We conclude that harnessing the innate biological properties of EVs, complemented by strategic engineering, represents a potential non-opioid strategy for precise and effective management of chronic pain.
    Keywords:  EV-based analgesic therapy; engineering EVs; exosomes; neuroimmune modulation; neuropathic pain; non-opioid treatment
    DOI:  https://doi.org/10.2147/IJN.S598699
  13. Adv Sci (Weinh). 2026 May 15. e75686
      The immunosuppressive bone marrow microenvironment (BMM) and cytokine dysregulation remain major barriers to curing multiple myeloma (MM). Despite the promise of B-cell maturation antigen (BCMA)-targeted therapies, their clinical utility is often limited by antigen escape and insufficient immune activation. Here, we developed DB Exo, a cell-free therapeutic platform utilizing allogeneic dendritic cell-derived exosomes engineered to surface display BCMA. Mechanistically, DB Exo act as molecular decoys that predominantly sequester soluble APRIL with partial BAFF attenuation, thereby effectively disrupting NF-κB pro-survival signaling in MM cells. Concurrently, DB Exo retain inherited costimulatory molecules (CD80, CD86, and MHC-II) to trigger strong host immune activation, expanding CD8+ T cells and enhancing the secretion of cytotoxic effector molecules. In an orthotopic murine model, DB Exo suppress tumor burden by ∼72% and remodel the BMM by increasing cytotoxic T-lymphocyte infiltration and elevating serum IFN-γ and Granzyme B levels. The robust antitumor efficacy was further validated in a subcutaneous model, with DB Exo achieving a ∼75% reduction in tumor weight. Our findings establish DB Exo as a potent bi-functional exosome platform that integrates targeted cytokine blockade with in situ immune activation, offering a promising cell-free strategy for MM treatment.
    Keywords:  APRIL/BAFF axis; BCMA; cell‐free therapy; dendritic cell‐derived exosomes; multiple myeloma
    DOI:  https://doi.org/10.1002/advs.75686
  14. Poult Sci. 2026 May 04. pii: S0032-5791(26)00691-7. [Epub ahead of print]105(8): 107062
      Necrotic enteritis (NE), caused by Clostridium perfringens (CP), remains one of the most economically consequential enteric diseases in broiler production, and currently available preventive strategies provide incomplete protection. Given the central role of necrotic enteritis B-like toxin (NetB) in NE pathogenesis, this study evaluated two NetB-targeted candidate prophylactic approaches and their effects on host immune responses and intestinal microbial dynamics. Sixty one-day-old Cobb broiler chickens were randomly assigned to four groups: an NE-positive control, an engineered Escherichia coli JC8031-treated group, a recombinant NetB-vaccinated group, and a non-challenged control. All groups except the non-challenged control were subjected to the same NE challenge conditions. NE was induced using an Eimeria-CP coinfection model combined with a high-protein diet. Challenged chickens received a 10-fold dose of COCCIVAC®-B on day 10, were fed a high-protein diet from day 15 to day 19 and were orally gavaged with the netB-positive CP54 strain from day 15 to day 18. Engineered Escherichia coli JC8031 expressing ClyA-NetB outer membrane vesicles (OMVs) was administered in drinking water from day 1 to day 18, whereas recombinant NetB protein was administered subcutaneously on days 1, 6, and 11. NE lesion scores, serum NetB-specific antibody responses, CP abundance, and jejunal microbiota composition were evaluated using lesion scoring, enzyme-linked immunosorbent assay, and full-length 16S rRNA gene sequencing. Both NetB-targeted approaches significantly increased serum NetB-specific antibody levels (P < 0.05), with the strongest humoral response observed after recombinant NetB immunization. However, these antibody responses did not result in significant reductions in intestinal lesion severity, NE incidence, or mortality under the present challenge conditions. Microbiota analysis showed that recombinant NetB immunization did not alter jejunal microbial composition following NE challenge. In contrast, continuous oral administration of engineered E. coli JC8031 was associated with reduced CP abundance and a shift in jejunal microbial composition toward a profile more similar to that of the non-challenged control. This pattern was supported by α-diversity indices, including Shannon diversity and Margalef richness, as well as by the relative abundance of Enterococcus faecium, which differed significantly from the NE-positive control and recombinant NetB groups but not from the non-challenged control. A relatively higher representation of Enterococcus taxa and Pediococcus acidilactici were also observed in the engineered E. coli JC8031 group, suggesting potential attenuation of CP-associated dysbiosis. Collectively, these findings indicate that induction of NetB-specific antibodies alone may be insufficient to mitigate NE outcomes under the present NE challenge conditions. Oral delivery of engineered E. coli-ClyA-NetB OMVs may provide microbiota-modulating benefits; however, further optimization is required to determine whether these effects can be translated into measurable clinical protection against NE.
    Keywords:  Escherichia coli JC8031; Jejunal microbiota; Necrotic enteritis; NetB; Outer membrane vesicles
    DOI:  https://doi.org/10.1016/j.psj.2026.107062
  15. Int J Pharm. 2026 May 12. pii: S0378-5173(26)00416-3. [Epub ahead of print]698 126968
      Milk-derived extracellular vesicles (MEVs) are widely recognized as promising natural nanocarriers for drug delivery. However, current drug-loading strategies predominantly rely on electroporation, which is often associated with low and inconsistent loading efficiency. This study aims to address these limitations. We further incorporated the widely used miRNA-carrying liposome Lipofectamine RNAiMAX to assess whether combining MEVs with liposomal delivery could enhance performance while reducing Lipofectamine-associated cytotoxicity. The outcomes of integrating these two delivery strategies were examined, and the underlying mechanisms were explored. Combining Lipofectamine with electroporated MEVs markedly improved target cell viability compared with Lipofectamine alone, although this was accompanied by a substantial reduction in loading efficiency. Despite increased cell viability, apoptosis-related gene expression remained almost unchanged. Transmission electron microscopy and the absence of notable changes in protein content after electroporation suggest that reduced Lipofectamine transfection efficiency may result from excessive membrane stacking and encapsulation. We believe this phenomenon is caused by excessive electrostatic attraction between the two membrane components, and considering that miRNAs also carry a negative charge, this may hinder the loading process. Therefore, we neutralized the electroporated MEVs with calcium chloride and then allowed the miRNAs to be loaded via passive diffusion and membrane self-repair. We demonstrate a strategy that significantly enhances and stabilizes the loading efficiency of natural MEVs without introducing exogenous components that are difficult to eliminate and could potentially elicit immune responses. This study paves the way for the future use of natural MEVs as nanomedicine carriers with low cytotoxicity, low immunogenicity, and potential homing capabilities.
    Keywords:  Electroporation; Extracellular vesicles; Lipofectamine; Membrane fusion; miRNA
    DOI:  https://doi.org/10.1016/j.ijpharm.2026.126968