Advances in Exosome‐Based Therapy for Cardiovascular Disease: Traditional Chinese Medicine Offering New Avenues for Exosome Functionalization

Abstract

ABSTRACT Background Cardiovascular diseases (CVDs) remain a leading cause of global mortality and impose a substantial health and economic burden worldwide. Exosomes, as promising endogenous nanocarriers, have emerged as a powerful tool for the prevention and treatment of CVDs. In particular, advanced functionalization strategies have largely enhanced exosomal therapeutic efficacy in vivo. Notably, Traditional Chinese Medicine (TCM) and its bioactive components exert profound regulatory effects on exosomes. Methods In this review, we systematically summarize exosome‐based therapeutic strategies for CVDs, along with state‐of‐art functionalization approaches to optimize exosomal cargo loading and targeted delivery. We further provide a comprehensive overview of TCM‐mediated exosomal regulation. Results We found that TCM and TCM‐derived chemicals can optimize exosomal cargo loading, especially the loading of microRNAs (miRNAs) and bioactive chemicals. More importantly, TCM and chemicals can promote exosomal secretion, which provides new avenues for exosomal‐scale production. Besides, there are synergistic effects between exosomes and TCM when co‐administered. Conclusion Collectively, exosome‐based systems hold great promise for CVD therapy, and TCM provides novel strategies for exosomal functionalization, which substantially enhances exosomal‐mediated therapeutic efficacy for CVDs.