细胞外囊泡介导的免疫调节与靶向递送：类风湿关节炎治疗的突破与挑战
Extracellular vesicle-mediated immunomodulation and targeted delivery: breakthroughs and challenges in rheumatoid arthritis therapy.
摘要(中文译文)
类风湿关节炎（RA）是一种以持续性滑膜炎、免疫失调和进行性关节破坏为特征的慢性自身免疫性疾病。其发病机制涉及多种因素，主要涉及免疫稳态的破坏，并伴随关节内局部炎症微环境的持续激活。不良反应、治疗耐药及疗效欠佳限制了当前临床干预措施的有效性。细胞外囊泡（EVs），包括外泌体、微囊泡和凋亡小体，是天然的囊泡载体，具有内在的生物相容性、低免疫原性和高效的细胞间通讯能力。通过递送多种生物活性分子，EVs可调节免疫细胞的活化与功能平衡，并可通过表面标志物修饰或功能分子工程实现治疗药物向RA病灶部位的靶向递送。该策略代表了风湿病学与免疫学研究的一个新兴方向。本综述系统总结了EVs在RA中免疫调节机制及靶向递送应用方面的最新进展，探讨了临床转化相关的技术局限与主要挑战，并为推进RA精准化和个体化治疗策略奠定了理论基础并提供了研究展望。
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by persistent synovitis, immune dysregulation, and progressive joint destruction. Its pathogenesis is multifactorial and primarily involves disruption of immune homeostasis, accompanied by sustained activation of the local inflammatory microenvironment within the joints. Adverse effects, therapeutic resistance, and suboptimal efficacy limit the effectiveness of current clinical interventions. Extracellular vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, are natural vesicular carriers with intrinsic biocompatibility, low immunogenicity, and efficient intercellular communication capacity. By delivering diverse bioactive molecules, EVs modulate immune cell activation and functional equilibrium and enable targeted delivery of therapeutic agents to RA lesion sites via surface marker modification or functional molecule engineering. This strategy represents an emerging direction in rheumatology and immunology research. This review systematically summarizes recent progress in the immunoregulatory mechanisms and targeted delivery applications of EVs in RA, examines the technical limitations and major challenges associated with clinical translation, and outlines a theoretical foundation and research perspectives for advancing precision and personalized therapeutic strategies for RA.
如何引用
AMA
Bo Yang, Heguo Yan, Ye Zhou, Jiajie Li, Juncheng Liu, Changxing Huang, et al. Extracellular vesicle-mediated immunomodulation and targeted delivery: breakthroughs and challenges in rheumatoid arthritis therapy.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1813097.
APA
Bo Yang, Heguo Yan, Ye Zhou, Jiajie Li, Juncheng Liu, Changxing Huang, et al (2026). Extracellular vesicle-mediated immunomodulation and targeted delivery: breakthroughs and challenges in rheumatoid arthritis therapy.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1813097
GB/T 7714
Bo Yang, Heguo Yan, Ye Zhou, Jiajie Li, Juncheng Liu, Changxing Huang, et al. Extracellular vesicle-mediated immunomodulation and targeted delivery: breakthroughs and challenges in rheumatoid arthritis therapy.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1813097.
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