Jin Yi, Xu Cong, Zhu Yujuan, Gu Zhifeng
Department of Rheumatology, Research Center of Clinical Medicine, Research Center of Immunology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, China.
Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States.
J Control Release. 2025 May 10;381:113610. doi: 10.1016/j.jconrel.2025.113610. Epub 2025 Mar 7.
Rheumatoid arthritis (RA) is a systemic autoimmune disorder characterized by chronic inflammation and progressive damage to connective tissue. It is driven by dysregulated cellular homeostasis, often leading to autoimmune destruction and permanent disability in severe cases. Over the past decade, various drug delivery systems have been developed to enable targeted therapies for disease prevention, reduction, or suppression. As an emerging therapeutic platform, extracellular vesicles (EVs) offer several advantages over conventional drug delivery systems, including biocompatibility and low immunogenicity. Consequently, an increasing number of studies have explored EV-based delivery systems in the treatment of RA, leveraging their natural ability to evade phagocytosis, prolong in vivo half-life, and minimize the immunogenicity of therapeutic agents. In this review, we first provide an in-depth overview of the pathogenesis of RA and the current treatment landscape. We then discuss the classification and biological properties of EVs, their potential therapeutic mechanisms, and the latest advancements in EVs as drug delivery platforms for RA therapy. We emphasize the significance of EVs as carriers in RA treatment and their potential to revolutionize therapeutic strategies. Furthermore, we examine key technological innovations and the future trajectory of EV research, focusing on the challenges and opportunities in translating these platforms into clinical practice. Our discussion aims to offer a comprehensive understanding of the current state and future prospects of EV-based therapeutics in RA.
类风湿性关节炎（RA）是一种全身性自身免疫性疾病，其特征为慢性炎症和结缔组织的进行性损伤。它由细胞内稳态失调驱动，在严重情况下常导致自身免疫性破坏和永久性残疾。在过去十年中，已开发出各种药物递送系统，以实现针对疾病预防、减轻或抑制的靶向治疗。作为一种新兴的治疗平台，细胞外囊泡（EVs）相较于传统药物递送系统具有多种优势，包括生物相容性和低免疫原性。因此，越来越多的研究探索了基于EVs的递送系统在类风湿性关节炎治疗中的应用，利用其天然的逃避吞噬作用、延长体内半衰期以及最小化治疗剂免疫原性的能力。在本综述中，我们首先深入概述类风湿性关节炎的发病机制和当前的治疗格局。然后，我们讨论细胞外囊泡的分类和生物学特性、其潜在的治疗机制，以及作为类风湿性关节炎治疗药物递送平台的细胞外囊泡的最新进展。我们强调细胞外囊泡作为类风湿性关节炎治疗载体的重要性及其革新治疗策略的潜力。此外，我们研究关键的技术创新和细胞外囊泡研究的未来发展轨迹，重点关注将这些平台转化为临床实践中的挑战和机遇。我们的讨论旨在全面了解基于细胞外囊泡的疗法在类风湿性关节炎中的现状和未来前景。
