As membrane structural bodies secreted by cells, extracellular vesicles (EVs) have become a hot topic in the field of plant science in recent years. Plant-derived extracellular vesicles (PDEVs) play a key role in both plant physiological activities and the interaction between plants and the environment. These vesicles are involved in plant growth, development, and response to adversity by delivering signaling molecules, proteins, and other bioactive substances. Current studies have shown that PDEVs also exhibit promising potential for clinical applications, including as drug carriers, vaccine development, and biomarkers for disease diagnosis. In this paper, we review studies related to compositional characterization, isolation and purification methods, biological roles, and clinical applications of PDEVs. We aim to provide a systematic theoretical basis and practical guidance for future studies to promote their application in biomedical fields.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. It is characterized by occult onset resulting in most patients being diagnosed at advanced stages and with poor prognosis. Exosomes are nanoscale vesicles with a lipid bilayer envelope released by various cells under physiological and pathological conditions, which play an important role in the biological information transfer between cells. There is growing evidence that HCC cell-derived exosomes may contribute to the establishment of a favorable microenvironment that supports cancer cell proliferation, invasion, and metastasis. These exosomes not only provide a versatile platform for diagnosis but also serve as a vehicle for drug delivery. In this paper, we review the role of exosomes involved in the proliferation, migration, and metastasis of HCC and describe their application in HCC diagnosis and treatment. We also discuss the prospects of exosome application in HCC and the research challenges.

The interaction between metabolic dysfunction-associated seatotic liver disease (MASLD) and gut microbiota regulates hepatic metabolic homeostasis through the gut-liver axis, and its mechanisms involve intestinal dysbiosis (decreased bacteroidetes, increased ratio of firmicutes/proteobacteria), bile acid metabolism reprogramming (secondary bile acids inhibit FXR signaling), short-chain fatty acid (SCFAs) deficiency, and endotoxin-mediated inflammatory activation (TLR4/NF-κB pathway). Among the intervention strategies, probiotics (such as Bifidobacteria) improved inflammation by regulating microbiota structure and intestinal barrier function, prebiotics such as resistant starch enriched butyric acid-producing bacteria and reduced liver lipid deposition, fecal microbiota transplantation (FMT) could remodel the microbiota but needed to optimize safety, restricted fructose intake and Mediterranean diet reduced liver damage by regulating microbiota metabolism, and metabolic surgery improved fibrosis through microbiota remodeling and bile acid signaling. In the future, it is necessary to combine multi-omics technology to analyze the microbiota-host interaction network, develop precision therapies such as phage targeted clearance or engineering bacterial delivery of metabolites, and promote the clinical transformation of personalized intervention programs.

As the world’s population ages, neurodegenerative diseases are becoming more widely acknowledged as serious global health and socioeconomic issues. Although many resources have been devoted to the research of these illnesses, little progress has been made in the creation of novel diagnostic and therapeutic approaches. Extracellular vesicles (EVs) are released by all cell types and contain proteins, microRNAs, mRNAs, and other biologically active molecules. EVs play an important role in intercellular communication as well as in the regulation of neuroinflammation. Determining the mechanisms by which EVs contribute to the pathogenesis of neurodegenerative diseases will aid in the development of new therapeutic approaches and diagnostic tools. Mesenchymal stem cells (MSCs) have been shown in studies to control immunological responses, promote the growth of new brain connections, promote the production of blood vessels, and heal damaged tissues. There is growing evidence that MSCs’ ability to treat patients is mostly due to the neurotrophic compounds they secrete through EVs. Since their tiny size allows them to pass through biological barriers and reach injured parts of the central nervous system, MSC-derived extracellular vesicles (MSC-EVs) retain many of the therapeutic qualities of their parent MSCs. This review discusses the role of EVs in neurodegenerative diseases and highlights the potential of MSC-EVs in the treatment of neurodegenerative diseases. The paper also examines the challenges that still need to be overcome and the prospects for using MSC-EVs to treat neurodegenerative illnesses.

Extracellular vesicles (EVs), serving as promising novel biomarkers for diseases, demonstrate extensive potential applications in disease diagnosis, prognosis evaluation, and treatment monitoring. Currently, EVs have made substantial advancements in the areas of disease diagnosis, prognosis, and treatment. Nevertheless, for EVs to be fully integrated into clinical laboratories, ongoing efforts are required in multi-omics integration and big data analysis, the development of clinically applicable separation and detection technologies, the establishment of standardized quality systems, as well as clinical trials and regulatory approval processes. This paper reviews the current status of the application of extracellular vesicles in disease diagnosis, prognostic assessment, and treatment monitoring, analyzes the challenges facing current research, and discusses future trends.

Extracellular vesicles (EVs) are nano-sized vesicles secreted by living cells and ubiquitously present in body fluids. They carry molecular cargo-including proteins, nucleic acids, and lipids-that accurately mirrors the physiological and pathological state of their parent cells, offering a highly promising novel source of biomarkers for liquid biopsy. This review systematically summarizes the progress in biomarker discovery and application of EVs in major diseases such as cancer, neurological disorders, and cardiovascular diseases. It provides an in-depth analysis of the key technical bottlenecks in current EV isolation, characterization, and detection methodologies, and discusses the challenges related to standardization and clinical translation. Finally, the review outlines the broad future prospects in this field, including integrated multi-omics analysis based on EVs, and their potential for early diagnosis, real-time therapeutic monitoring, and prognostic assessment.