Table 2 Multiple modified EVs encapsulate therapeutic cargo targeting various organs

Heart

CPCs

Transfection of miR-322 by electroporation after isolation of exosomes

miR-322

Tail intravenous injection

CPC-EV loaded with miR-322 can treat ischemic cardiovascular disease

[134]

BMSC

Transfection of Lamp-2b with IMTP plasmid

Targeting peptide IMTP

Intravenous injections

IMTP-EVs are more easily taken up by hypoxia-injured cells, improving myocardial function

[108]

CDCs

Transfection of Lamp-2b with CMP plasmid

Targeting peptide CMP

Intramyocardial injections and retroorbital intravenous injection

CMP-EVs improve selective targeting of ischemic heart tissue

[109]

BMSCs(with hypoxic conditions)

Combine with IMT peptides through bio-orthogonal chemistry

miR-125b-5p

Intravenously injection

Improve the targeting efficiency of EV, reduce cardiomyocyte apoptosis and reduce off-target

[135]

MSC

Platelet membranes to envelope EVs

–

Intravenous injections

Significantly increase the uptake of EVs by endothelial cells and cardiomyocytes, and reduce the phagocytosis of macrophages

[136]

Brain

MSC

Use click chemistry to couple functional ligands to the EV surface

Cur

Tail intravenous injection

cRGD-EV targets the ischemic brain injury area and inhibits inflammation and apoptosis in this area

[137]

HEK 293 T cell line

Transfection of RVG peptide plasmid and mu (MOR) siRNA into donor cells

MOR siRNA

Intravenously injected

RVG EVs encapsulating MOR siRNA cross the BBB and target the central nervous system to treat drug addiction

[138]

whole blood of SD rats

Coupling mAb GAP43 to the surface of Que-EV using the carbodiimide method

Quercetin

Tail intravenous injection

Que/mAb GAP43-EV enhances the accumulation of Que drugs at the site of cerebral ischemia injury and reduces the infarct size

[139]

Neutrophil

–

Dox

Intracardiac injection; intravenously injected

NEs-EVs carries Dox across the BBB to target brain tumors

[140]

Raw264.7

Combine RGE peptides with EVs loaded with SPION and Cur by click chemistry

SPIONs and Cur

Tail intravenous injection

RGE-EV-SPION/Cur can cross the blood–brain barrier, accurately identify and treat gliomas

[110]

Lung

BMM

Combine the mixture of EVs and DSPE-PEG-AA using ultrasound and PTX

PTX

Tail intravenous injection

AA-PEG-EV specifically delivers PTX to lung metastases

[141]

Bone

Dendritic cells

CAP-EV was synthesized by transfection of CAP-lamp2b plasmid

miR-140

Intraarticular injection

CAP-EVs remain in the joint cavity, deliver miR-140 to deep cartilage regions, and alleviate OA progression

[25]

Endothelial cells

–

miR-155

Intraperitoneally injection

EC-EV is specifically taken up by BMMs, among which miR-155 inhibits osteoclast activity and reverses osteoporosis

[80]

NIH-3T3 cells

Plasmid transfection enables high expression of CXCR4 on the surface of EVs

Antagomir-188

Tail intravenous injection

CXCR4-positive EVs could be recruited to the bone marrow

[79]

Skin

Human adipose tissue-derived mesenchymal stem cell

–

–

Intravenously or subcutaneously

Topical application

[142]

Liver

MSC

The EVs modified with cationized pullulan

–

Tail intravenous injection

The modified EVs accumulated in the liver tissue, resulting in a greater therapeutic effect on liver injury

[128]

Breast

imDCs

Transfect iRGD peptide binds to the exosomal surface membrane protein Lamp-2b

Dox

–

iRGD-EVs-Dox can be specifically delivered to the breast, playing a highly effective anti-tumor effect

[143]

Colon

Raw264.7

Produce HDEA@EVs including PH response HDEA, hyaluronic acid and Dox

Dox

Tail intravenous injection

HDEA@EVs specifically binds to the CD44 receptor on the tumor surface and delivers Dox to colon cancer tumor cells

[144]