Stem cell-derived exosomes in complicated urinary tract infections: immunomodulatory mechanisms and potential therapeutic strategies for urothelial repair.

Complicated urinary tract infection (cUTI), characterized by recurrent episodes due to multidrug-resistant bacterial infections and biofilm formation, severely compromises patients' quality of life. Although uropathogenic Escherichia coli remains the primary pathogen, its ability to form biofilms and induce persistent inflammatory responses exacerbates urothelial damage, thereby aggravating the disease. Current antibiotic treatments face resistance issues and inability to promote tissue repair, emphasizing the need for innovative treatments. Stem cell-derived exosomes have emerged as a promising solution for cUTI treatment due to their unique anti-inflammatory and tissue-repairing properties. In addition, advancements in targeted drug delivery and biomaterial integration have increased drug stability and therapeutic precision. These innovations have the potential to revolutionize the treatment of multidrug-resistant bacterial infections and the repair of complicated tissue damage, offering improved patient outcomes and addressing the limitations of traditional therapies.