Atherosclerosis (AS) is a chronic inflammatory vascular disease characterized by the accumulation of lipids and inflammatory debris in large arteries, high morbidity, and AS-related disease mortality. AS is a complex process, involving endothelial cell dysfunction and inflammation, smooth muscle cell proliferation, and macrophage activation. However, the currently available therapies for AS are not ideal, thus requiring development of novel treatment strategies. Exosomes are bi-lipid membranous extracellular containing multifarious cargo, such as proteins, lipids, micro ribonucleic acid (miRNAs), messenger RNAs, and long non-coding RNAs. Moreover, exosomes reportedly participate in various AS processes. Specifically, stem cell-derived exosomes can regulate the occurrence and development of AS, exhibiting the ability to overcome the limitations associated with AS treatment and stem cell therapy. In this paper, we review the pathological mechanism of AS and discuss the role of exosomes and stem cell-derived exosomes in AS progression. We conclude by suggesting new therapeutic strategies for treating AS with stem cell-derived exosomes in the hope of improving the clinical treatment of AS.

动脉粥样硬化（AS）是一种慢性炎症性血管疾病，其特征是脂质和炎症碎片在大动脉中积聚，发病率高，AS相关疾病死亡率高。AS 是一个复杂的过程，涉及内皮细胞功能障碍和炎症、平滑肌细胞增殖和巨噬细胞活化。然而，目前可用的 AS 疗法并不理想，因此需要开发新的治疗策略。外泌体是双脂质膜细胞外，含有多种物质，如蛋白质、脂质、微核糖核酸 (miRNA)、信使 RNA 和长链非编码 RNA。此外，据报道外泌体参与了各种 AS 过程。具体来说，干细胞来源的外泌体可以调控AS的发生发展，表现出克服与 AS 治疗和干细胞治疗相关的局限性的能力。在本文中，我们回顾了 AS 的病理机制，并讨论了外泌体和干细胞衍生的外泌体在 AS 进展中的作用。最后，我们提出了用干细胞衍生的外泌体治疗 AS 的新治疗策略，以期改善 AS 的临床治疗。