Abstract: Mesenchymal stromal cells (MSCs) hold significant therapeutic potential, but their clinical application is often hindered by limitations such as donor variability. MSC-derived extracellular vesicles (EVs) present a promising alternative, offering comparable or superior therapeutic effects while overcoming some of these challenges. MSC-EVs exhibit strong anti-inflammatory and immunomodulatory properties, which could be leveraged in neurodegenerative diseases given the central role of neuroinflammation in these conditions. Additionally, MSC-EVs can be engineered for targeted drug delivery, enhancing their clinical utility. In this review we highlight the dual role of MSC-EVs as immunomodulators and drug carriers in neurodegenerative disorders. We discuss the current challenges, and outline strategies for clinical translation. Future advances in understanding MSC-EVs and their mechanisms of action could support their development into effective therapies for neurodegenerative diseases.
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