Unleashing the potential of extracellular vesicles for ulcerative colitis and Crohn's disease therapy

Inflammatory bowel disorders (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions of the gastrointestinal tract (GIT). They pose significant treatment challenges due to their complex etiology. Current therapies focus on reducing inflammation but often prove inadequate, leading to a substantial need for novel approaches. Cell therapy looks promising, especially using mesenchymal stromal cells (MSCs) and their secretome, including extracellular vesicles (EVs). EVs are nano-sized vesicles that are non-replicating and carry bioactive molecules that modulate immune responses, promote tissue repair, can facilitate drug delivery and, therefore, hold great therapeutic promise. This review summarizes the role of EVs as a cell-free therapy for IBD, highlighting opportunities for further investigation and potential clinical applications. [Display omitted] •Comprehensive review of MSC-derived EVs as therapeutic agents for IBD.•MSC-EVs modulate immune responses and promote tissue repair in CD and UC.•EVs enhance therapeutic effects and reduce toxicity as drug delivery systems in preclinical colitis models.•Current clinical studies assess the safety and efficacy of MSC-derived EVs for IBD treatment.•Key challenges scaling production, standardizing isolation addressing EV heterogeneity, and optimizing delivery.