Extracellular vesicles (EVs) are heterogeneous membranous vesicles secreted by living cells that are involved in many physiological and pathological processes as intermediaries for intercellular communication and molecular transfer. Recent studies have shown that EVs can regulate the occurrence and development of tumors by transferring proteins, lipids and nucleic acids to immune cells as signaling molecules. As a new diagnostic biomarker and drug delivery system, EVs have broad application prospects in immunotherapy. In addition, the breakthrough of nanotechnology has promoted the development and exploration of engineered EVs for immune-targeted therapy. Herein, we review the uniqueness of EVs in immune regulation and the engineering strategies used for immunotherapy and highlight the logic of their design through typical examples. The present situation and challenges of clinical transformation are discussed, and the development prospects of EVs in immunotherapy are proposed. The goal of this review is to provide new insights into the design of immune-regulatory EVs and expand their application in cancer immunotherapy.

细胞外囊泡（EVs）是由活细胞分泌的异质膜囊泡，作为细胞间通讯和分子转移的中介，参与许多生理和病理过程。最近的研究表明，EVs可以通过将蛋白质、脂质和核酸作为信号分子转移到免疫细胞中来调节肿瘤的发生和发展。EVs作为一种新型的诊断生物标志物和药物递送系统，在免疫治疗中具有广阔的应用前景。此外，纳米技术的突破促进了用于免疫靶向治疗的工程电动汽车的开发和探索。在此，我们回顾了 EV 在免疫调节中的独特性以及用于免疫治疗的工程策略，并通过典型示例突出了它们的设计逻辑。讨论了临床转化的现状和挑战，提出了电动汽车在免疫治疗中的发展前景。本综述的目的是为免疫调节电动汽车的设计提供新的见解，并扩大其在癌症免疫治疗中的应用。