Engineering Extracellular Vesicles: Strategies for Functional Modification and Clinical Translation

Abstract

Extracellular vesicles (EVs), as endogenous nanoscale delivery platforms, have garnered significant attention due to their high biocompatibility, low immunogenicity, and intrinsic ability to cross physiological barriers. However, the clinical translation of natural EVs is hindered by inherent limitations, including poor targeting specificity, low drug‐loading capacity, high heterogeneity, and challenges in achieving standardized manufacturing. Engineering EVs through physical, chemical, and biological modification strategies can significantly enhance their targeting precision, drug‐loading efficiency, and pharmacokinetic profiles. This review summarized the mainstream approaches for engineering EVs and elaborated on recent applications of functionalized EVs in relevant biomedical fields. Furthermore, it discussed current challenges and future perspectives regarding the large‐scale production, standardized characterization, and safety evaluation of engineered EVs.