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Neurodegenerative diseases (NDDs) such as Alzheimer’s, Parkinson’s, ALS, and Huntington’s pose a growing global challenge due to their complex pathobiology and aging demographics. Once considered as cellular debris, small extracellular vesicles (sEVs) are now recognized as active mediators of intercellular signaling in NDD progression. These nanovesicles (~30–150 nm), capable of crossing the blood–brain barrier, carry pathological proteins, RNAs, and lipids, facilitating the spread of toxic species like Aβ, tau, TDP-43, and α-synuclein. sEVs are increasingly recognized as valuable diagnostic tools, outperforming traditional CSF biomarkers in early detection and disease monitoring. On the therapeutic front, engineered sEVs offer a promising platform for CNS-targeted delivery of siRNAs, CRISPR tools, and neuroprotective agents, demonstrating efficacy in preclinical models. However, translational hurdles persist, including standardization, scalability, and regulatory alignment. Promising solutions are emerging, such as CRISPR-based barcoding, which enables high-resolution tracking of vesicle biodistribution; AI-guided analytics to enhance quality control; and coordinated regulatory efforts by the FDA, EMA, and ISEV aimed at unifying identity and purity criteria under forthcoming Minimal Information for Studies of Extracellular Vesicles (MISEV) guidelines. This review critically examines the mechanistic roles, diagnostic potential, and therapeutic applications of sEVs in NDDs, and outlines key strategies for clinical translation. Full article

In recent years, there has been a dynamic development in therapies utilizing extracellular vesicles (EVs) including exosomes. Therefore, we have conducted an analysis of the scientific literature to verify the current state of knowledge about these therapies. A total of 12 clinical studies were analyzed, covering the use of EVs in treating skin aging, acne scars, alopecia, and wound healing. The results indicate that EVs and exosomes hold potential in regenerative skin therapies, offering innovative and non-invasive therapeutic approaches. At the same time, significant challenges related to the standardization of their production and the lack of large-scale randomized studies were identified. Thus, we also evaluated the investigated clinical trials in regard to the MISEV (Minimal Information for Studies of Extracellular Vesicles) criteria. This review provides a comprehensive overview of the contemporary applications of EVs in skin therapy and regenerative medicine, highlighting directions for further research. Full article

In the tenth year since the first edition of MISEV was released in 2014, MISEV2023 has been reported in 2024 with the aim of refining the standard and improving the rigor, reproducibility, and transparency of extracellular vesicle (EV) research to clarify the requirements for experimental design of EVs, emphasize the importance of reproducible experimental results as well as encouraging openness of experimental information. The release of MISEV has significantly contributed to the quality of research in the field of EVs, which creates a more reliable research environment. However, despite the important role of MISEV, there is still a need for the EV researchers to continue to push for the widespread implementation of the guidelines to meet the evolving nature and challenges of EV research. The evolution of EV research and the attention it receives have grown exponentially over time, as has the number of people involved in the writing of MISEV. Here, this review briefly summarizes the evolution of the three editions of MISEV, aiming to recall MISEV2014 and MISEV2018 while learning about the latest release, MISEV2023, to gain a deeper understanding of the content, and to provide a quick note for beginners who want to learn about MISEV and explore the EV world. Full article