Mohiyuddin Shanid, Dipankar Pankaj, Robinson Belfin, Jeyabose Andrew, Karthikeyan J
Department of Medicine, University of Missouri, Columbia, MO, United States.
National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, United States.
Front Med (Lausanne). 2025 Jul 21;12:1599392. doi: 10.3389/fmed.2025.1599392. eCollection 2025.
The clinical translation of safe and effective therapeutic methods for brain cancer treatment is a major challenge that persists in modern medicine. The insufficient drug delivery into the regime of the affected brain tissue due to blood-brain barrier (BBB) restriction leads to a poor prognosis of the disease. However, an alternative strategy using biomaterials like exosomes can offer advancements in the treatment of brain cancer. Exosomes are a type of extracellular microvesicle with a diameter of 30-100 nm, principally functioning as intercellular mediators in the cell signaling process. Due to their biological origin, exosomes demonstrate a significant ability to cross the BBB and possess enhanced biocompatibility, high drug-loading capacity, and low immunogenicity. With the innate property of biomolecule delivery, exosomes also offer enhanced cellular uptake, rendering them exceptional in drug delivery systems. Herein, we focus on the anticancer and diagnostic applications of exosomes for brain cancer therapeutics. The enhancement of the physico-chemical properties of various cell-derived exosomes can be effectively used as a prime drug delivery agent in most treatment strategies. The biphasic and fast drug release in acidic pH of the tumor microenvironment by exosome-mediated drug delivery system contributes to passive targeting, which is often considered advantageous over other drug delivery platforms. These characteristic features are likely to enhance the therapeutic potential and efficacy of the treatment. The exosome loaded with the drug acts as an efficient biomaterial to surpass the BBB, followed by efficient cellular uptake, leading to cytotoxicity in glioblastoma cells. In this review, we summarize the recent updates in theranostic and prognostic strategies using exosomes as a mediator and their prevalence in biomedical applications, with a focus on brain cancer diseases.
脑癌治疗中安全有效的治疗方法的临床转化是现代医学中持续存在的一项重大挑战。由于血脑屏障（BBB）的限制，药物向受影响脑组织区域的递送不足导致该疾病预后不良。然而，使用外泌体等生物材料的替代策略可以为脑癌治疗带来进展。外泌体是一种直径为30 - 100纳米的细胞外微泡，主要在细胞信号传导过程中作为细胞间介质发挥作用。由于其生物学来源，外泌体显示出显著的穿越血脑屏障的能力，并具有增强的生物相容性、高载药能力和低免疫原性。凭借生物分子递送的固有特性，外泌体还具有增强的细胞摄取能力，使其在药物递送系统中表现出色。在此，我们专注于外泌体在脑癌治疗中的抗癌和诊断应用。各种细胞来源的外泌体理化性质的增强在大多数治疗策略中可有效地用作主要的药物递送剂。外泌体介导的药物递送系统在肿瘤微环境的酸性pH值下实现双相快速药物释放，有助于被动靶向，这通常被认为比其他药物递送平台更具优势。这些特征可能会增强治疗的潜力和疗效。载有药物的外泌体作为一种有效的生物材料，能够跨越血脑屏障，随后实现高效的细胞摄取，从而导致胶质母细胞瘤细胞的细胞毒性。在本综述中，我们总结了使用外泌体作为介质的治疗诊断和预后策略的最新进展及其在生物医学应用中的普遍性，重点关注脑癌疾病。
