To systematically review the modification methods, targeting strategies, and therapeutic effects of engineered extracellular vesicles (EVs) in the treatment of ischemic heart disease (IHD), highlighting their significance in improving treatment outcomes.
Key Findings:
50 animal studies were included in the review, indicating a robust dataset.
Engineering modifications of EVs were achieved through internal loading/knockdown, surface modification, and membrane fusion, which enhance their therapeutic potential.
Targeting strategies included the use of peptides or specific antibodies to enhance targeting enrichment for ischemic myocardium, improving treatment efficacy.
Engineered EVs improved cardiac function by alleviating myocardial fibrosis, inhibiting inflammatory responses, promoting angiogenesis, reducing cardiomyocyte apoptosis, and improving mitochondrial metabolism, suggesting a multi-faceted approach to therapy.
Interpretation:
The modification methods of engineered EVs form a composite system that addresses multi-targeted synergy, precise delivery, and long-lasting effects in IHD treatment, potentially leading to improved patient outcomes.
Limitations:
The review is based on animal studies, which may not fully translate to human applications, necessitating caution in interpretation.
The search timeframe extends only to March 2026, potentially missing relevant future studies that could impact findings.
Conclusion:
The systematic review provides a theoretical basis and practical guidance for constructing multifunctional EVs delivery systems for IHD treatment, emphasizing the need for further research to accelerate clinical translation.
In a target-trial emulation of more than 600,000 veterans, GLP-1 RA initiators saw fewer new substance use disorders—and patients with existing SUDs had fewer overdoses, hospitalizations, and deaths.
