Background: Exosomes are nanosized extracellular vesicles that range from 30 to 150 nm and have a bilayer lipid membrane which encapsulates proteins, lipids, and nucleic acids, first identified in the 1960s and expanded in application from disease diagnostics to targeted therapeutics. They are intercellular communicators with roles in physiological regulation and pathological progression. Results: Exosomes applications in gene therapy, drug delivery, tissue regeneration, and disease diagnostics activate signaling pathways such as Wnt/β-catenin, PI3K/Akt, etc., deliver anti-aging molecules, and promote angiogenesis refers to their properties such as biocompatibility, cross the blood-brain barrier, serving as vectors and selective cargo delivery. Altogether, these effects promote tissue regeneration, as well as its therapeutic potential in dermatology, orthopedics, cardiology, neurology, and wound healing. However the same mechanisms that promote regeneration can also drive tumor progression, induce drug resistance, suppress immune responses, and mediate the pathogenic factors spread. It means that exosome's dual nature presents challenges. On the therapeutic side, exosomes can promote tumor growth, drug resistance, and immune suppression. In contrast, the transmission of viral or pathogenic proteins, tumor progression, and so on, underscores their “Trojan horse” potential. Conclusion: Exosomes embody a biological paradox as mentioned. It is essential for developing safe and effective exosome based therapies to understanding of this duality deeper for harnessing their therapeutic potential while mitigating associated risks.

Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders in women during their reproductive years and is associated with a wide range of reproductive, metabolic, and psychological complications. This review aims to synthesize current knowledge regarding the complex pathophysiology of PCOS, focusing on the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome's role in mediating inflammation and metabolic dysfunction. Additionally, we explore the therapeutic potential of herbal medicines in modulating the NLRP3 pathway, highlighting their multi-targeted mechanisms of action. The bioactive compounds derived from various medicinal plants may effectively regulate NLRP3 inflammasome activation, thereby alleviating the symptoms associated with PCOS. As PCOS continues to pose significant health challenges for women worldwide, this review emphasizes the necessity for innovative therapeutic strategies that integrate traditional knowledge with modern scientific approaches.