Engineering extracellular vesicles for inflammatory bowel disease and colitis-associated colorectal cancer: from therapeutic innovation to clinical translation
5 affiliations
- 1Department of Laboratory Medicine, School of Clinical Medicine and Laboratory Medicine, Jiangsu University
- 2The People’s Hospital of Danyang, Affiliated Danyang Hospital of Nantong University
- 3Department of Gastrointestinal and Endoscopy, The Affiliated Yixing Hospital of Jiangsu University
- 4Department of Laboratory Medicine, The Second People's Hospital of Lianyungang
- 5Department of Laboratory Medicine, Affiliated Lianyungang Clinical College of Jiangsu University
Abstract
Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic relapsing inflammatory disorder that increases the risk of colitis-associated colorectal cancer (CAC). Despite major advances in biologics and small-molecule therapies, many patients experience primary or secondary treatment failure, adverse effects, and disease recurrence, underscoring the need for more effective, targeted therapeutic strategies. Extracellular vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, have emerged as promising nanoscale therapeutic platforms owing to their intrinsic biocompatibility, low immunogenicity, cargo-protective lipid bilayer, and natural ability to mediate intercellular communication. Recent advances in EV engineering have further expanded their therapeutic potential through genetic modification of parental cells, cargo loading, surface functionalization, and hybrid biomaterial systems, enabling enhanced targeting, drug delivery, immune modulation, tissue regeneration, and anti-tumor activity. This review summarizes the biological characteristics of EVs and discusses recent progress in engineering strategies aimed at improving their therapeutic efficacy in IBD and CAC. We critically evaluate current preclinical evidence regarding immunomodulation, restoration of intestinal barrier integrity, regulation of gut microbiota, targeted drug delivery, cancer immunotherapy, and inhibition of metastasis. Finally, we discuss the major translational challenges, including manufacturing standardization, quality control, large-scale production, safety evaluation, regulatory considerations, and future perspectives necessary for successful clinical implementation of engineered EV-based therapies.
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BibTeX
@article{huang2026engineering,
title = {{Engineering extracellular vesicles for inflammatory bowel disease and colitis-associated colorectal cancer: from therapeutic innovation to clinical translation}},
author = {Minrui Huang and Jintao Yuan and Peter Muro and Tao Jin and Fei Mao and Wenjun Zhu},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1933602},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1933602/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Engineering extracellular vesicles for inflammatory bowel disease and colitis-associated colorectal cancer: from therapeutic innovation to clinical translation
AU - Minrui Huang
AU - Jintao Yuan
AU - Peter Muro
AU - Tao Jin
AU - Fei Mao
AU - Wenjun Zhu
PY - 2026
DA - 2026/10/07
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1933602
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1933602/full
AB - Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, is a chronic relapsing inflammatory disorder that increases the risk of colitis-associated colorectal cancer (CAC). Despite major advances in biologics and small-molecule therapies, many patients experience primary or secondary treatment failure, adverse effects, and disease recurrence, underscoring the need for more effective, targeted therapeutic strategies. Extracellular vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, have emerged as promising nanoscale therapeutic platforms owing to their intrinsic biocompatibility, low immunogenicity, cargo-protective lipid bilayer, and natural ability to mediate intercellular communication. Recent advances in EV engineering have further expanded their therapeutic potential through genetic modification of parental cells, cargo loading, surface functionalization, and hybrid biomaterial systems, enabling enhanced targeting, drug delivery, immune modulation, tissue regeneration, and anti-tumor activity. This review summarizes the biological characteristics of EVs and discusses recent progress in engineering strategies aimed at improving their therapeutic efficacy in IBD and CAC. We critically evaluate current preclinical evidence regarding immunomodulation, restoration of intestinal barrier integrity, regulation of gut microbiota, targeted drug delivery, cancer immunotherapy, and inhibition of metastasis. Finally, we discuss the major translational challenges, including manufacturing standardization, quality control, large-scale production, safety evaluation, regulatory considerations, and future perspectives necessary for successful clinical implementation of engineered EV-based therapies.
SN - 1664-3224
ER -