Extracellular vesicles (EVs)—naturally occurring nanoscale carriers—address multiple aging hallmarks simultaneously: chronic inflammation, mitochondrial dysfunction, genomic damage, and intercellular miscommunication. This review establishes a framework connecting EV mechanisms with engineering strategies and clinical translation, positioning engineered EVs as a scalable therapeutic platform for systemic rejuvenation.
Key Points
- EVs suppress senescence signaling and restore mitochondrial function and metabolic health
- Engineered targeting and delivery overcome heterogeneity and tissue penetration barriers
- Scalable manufacturing and standardized quality control enable clinical translation
Longevity Analysis
The aging process reflects accumulated dysfunction across interconnected networks—senescent cells driving chronic inflammation, mitochondrial efficiency declining, repair pathways faltering, organs communicating less effectively. EVs operate across all these domains simultaneously: they neutralize inflammatory signals from senescent cells, restore the energy-producing capacity of mitochondria, activate DNA repair, and improve cross-organ coordination. Unlike single-target interventions, this approach addresses aging as a systems problem. The gap between mechanism and implementation remains significant—delivery efficiency, manufacturing consistency, and long-term safety must be resolved before clinical deployment—but the theoretical foundation is robust and the engineering solutions are advancing rapidly.
Original published by Wiley Aging Cell, by Xian Huang, Qiujie Li, Guofang Tao, Xulin Gan, Jiangjie Lu, Sergei Krasny, Liyun Shi .