Interactions between extracellular vesicles and microbiome in human diseases: New therapeutic opportunities

In recent decades, accumulating research on the interactions between microbiome homeostasis and host health has broadened new frontiers in delineating the molecular mechanisms of disease pathogenesis and developing novel therapeutic strategies. By transporting proteins, nucleic acids, lipids, and metabolites in their versatile bioactive molecules, extracellular vesicles (EVs), natural bioactive cell-secreted nanoparticles, may be key mediators of microbiota-host communications. In addition to their positive and negative roles in diverse physiological and pathological processes, there is considerable evidence to implicate EVs secreted by bacteria (bacterial EVs [BEVs]) in the onset and progression of various diseases, including gastrointestinal, respiratory, dermatological, neurological, and musculoskeletal diseases, as well as in cancer. Moreover, an increasing number of studies have explored BEV-based platforms to design novel biomedical diagnostic and therapeutic strategies. Hence, in this review, we highlight the recent advances in BEV biogenesis, composition, biofunctions, and their potential involvement in disease pathologies. Furthermore, we introduce the current and emerging clinical applications of BEVs in diagnostic analytics, vaccine design, and novel therapeutic development. Bacterial extracellular vesicles (BEVs) derived from various commensal and pathogenic bacteria have been shown to participate in a wide range of physiological and pathological processes by transporting versatile bioactive molecules, including proteins, nucleic acids, lipids, and metabolites. BEVs are intensively involved in the onset and progression of various diseases and BEV-based platforms possess great potential in diagnostic analytics, vaccine design, and novel therapeutic development.Highlightsimage Bacterial extracellular vesicles (BEVs) are key intermediators of microbiota-host communications by transporting their versatile bioactive cargoes, including proteins, nucleic acids, lipids, and metabolites.BEVs are proposed to exert both positive and negative roles in diverse physiological and pathological processes.BEVs secreted by pathogenic bacteria are strongly associated with the onset and progression of various human pathologies.BEV-based platforms show promising clinical potential, including application in diagnostic analytics, vaccine design, and novel therapeutic development.