# Native and Engineered Extracellular Vesicles for the Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome

## TL;DR

This paper reviews how natural and modified extracellular vesicles can be used to treat severe lung conditions like acute respiratory distress syndrome.

## Contribution

The paper provides a comprehensive overview of engineering strategies to enhance extracellular vesicles for ALI/ARDS treatment.

## Key findings

- Extracellular vesicles are biocompatible and do not trigger immune rejection, making them suitable for therapeutic use.
- Engineering strategies can improve the clinical potential of extracellular vesicles for treating lung injuries.
- The paper discusses challenges and opportunities in translating extracellular vesicle therapies to clinical settings.

## Abstract

Extracellular vesicles (EVs) are lipid bilayer nanoparticles naturally released from cells, playing a crucial role in intercellular communication. They modulate gene expression and regulate physiological and pathological processes, including acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Research has shown that EVs contain a variety of active components, are biocompatible and small in size, and do not trigger immune rejection, making the infusion of exogenous EVs a promising therapeutic tool. With further research, engineering strategies have been proposed to enhance the clinical potential of EVs. These strategies involve modifying either donor cells that secrete EVs or the EVs themselves and can be engineered to circumvent the limitations of native EVs. In this review, an overview of the biological properties of native EVs is provided and the current therapeutic potential of native and engineered EVs in treating ALI/ARDS, along with the latest research findings, is summarized. The challenges and opportunities for clinical translation of EVs as a novel therapeutic tool are also discussed, offering new insights into the treatment of ALI/ARDS using EV engineering technology.

Both native and engineered extracellular vesicles (EVs) are served as promising therapeutic agents for treating acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). To circumvent the limitations of native EVs, various engineering strategies are adopted. The challenges and opportunities for clinical translation of EVs are also discussed, providing new perspectives for EV‐based therapy.© 2025 WILEY‐VCH GmbH