Extracellular vesicles (EVs) are vehicles of intercellular communication that are released from various cell types under physiological and pathological conditions, with differing effects on the body. Under physiological conditions, EVs mediate cell-to-cell and intertissue communication and participate in maintaining homeostasis. Certain EV types have emerged as biological therapeutic agents in various fields, such as cell-free regenerative medicine, drug delivery and immunotherapy. However, the low yield of EVs is a bottleneck in the large-scale implementation of these therapies. Conversely, more EVs in the microenvironment in other circumstances, such as tumor metastasis, viral particle transmission, and the propagation of neurodegenerative disease, can exacerbate the situation, and the inhibition of EV secretion may delay the progression of these diseases. Therefore, the promotion and inhibition of EV release is a new and promising field because of its great research potential and wide application prospects. We first review the methods and therapeutic opportunities for the regulation of EV release based on the mechanism of EV biogenesis and consider the side effects and challenges.

细胞外囊泡 (EVs) 是细胞间通讯的载体，在生理和病理条件下从各种细胞类型中释放出来，对身体有不同的影响。在生理条件下，EVs 介导细胞间和组织间的通讯并参与维持体内平衡。某些 EV 类型已成为各个领域的生物治疗剂，例如无细胞再生医学、药物递送和免疫治疗。然而，电动汽车的低产量是这些疗法大规模实施的瓶颈。相反，在其他情况下，微环境中更多的 EV，例如肿瘤转移、病毒颗粒传播和神经退行性疾病的传播，会加剧这种情况，而抑制EV分泌可能会延缓这些疾病的进展。因此，EV释放的促进和抑制具有巨大的研究潜力和广阔的应用前景，是一个新兴的、有发展前景的领域。我们首先回顾了基于 EV 生物发生机制的 EV 释放调节方法和治疗机会，并考虑了副作用和挑战。