Fang H, Wang JP, Li BB. Extracellular vesicles in allergic rhinitis: Immune regulatory mechanisms and therapeutic applications. World J Stem Cells 2026; 18(6): 120502 [DOI: 10.4252/wjsc.120502]
Corresponding Author of This Article
Jia-Ping Wang, Research Fellow, Department of Pediatrics, Shaoxing Central Hospital, Affiliated Central Hospital of Shaoxing University, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. w2846a@163.com
Research Domain of This Article
Allergy
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Stem Cells. Jun 26, 2026; 18(6): 120502 Published online Jun 26, 2026. doi: 10.4252/wjsc.120502
Extracellular vesicles in allergic rhinitis: Immune regulatory mechanisms and therapeutic applications
Hao Fang, Jia-Ping Wang, Bing-Bing Li
Hao Fang, Jia-Ping Wang, Bing-Bing Li, Department of Pediatrics, Shaoxing Central Hospital, Affiliated Central Hospital of Shaoxing University, Shaoxing 312030, Zhejiang Province, China
Author contributions: Fang H led the drafting of the initial manuscript, design and production of figures, undertook the construction and improvement of the core content of the manuscript, and assumed the main research workload; Wang JP and Li BB participated in the critical revision of the manuscript and assumed the secondary workload; Wang JP assisted in improving the academic content and checking details; Li BB assisted in sorting out the academic logic and optimizing the expression. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Jia-Ping Wang, Research Fellow, Department of Pediatrics, Shaoxing Central Hospital, Affiliated Central Hospital of Shaoxing University, No. 1 Huayu Road, Keqiao District, Shaoxing 312030, Zhejiang Province, China. w2846a@163.com
Received: February 28, 2026 Revised: March 12, 2026 Accepted: April 8, 2026 Published online: June 26, 2026 Processing time: 117 Days and 18.9 Hours
Abstract
Allergic rhinitis (AR) is a prevalent chronic inflammatory disease worldwide, characterized by Th1/Th2 immune imbalance, nasal mucosal barrier disruption, and complex interactions among various immune cells. Current pharmacological therapies are primarily symptomatic, often failing to correct underlying immune dysregulation and presenting limitations for long-term use. In recent years, extracellular vesicles (EVs), as key mediators of intercellular communication, have demonstrated significant potential in the immune regulation, diagnosis, and treatment of AR. This review systematically highlights the dual role of EVs in AR pathogenesis. On one hand, immune cell-derived EVs can exacerbate Th2-driven immune responses and inflammatory progression by transporting bioactive molecules, such as microRNAs. On the other hand, mesenchymal stem cell-derived EVs demonstrate potent immunomodulatory and tissue-repair capabilities, regulating the activity of dendritic cells, T cells, B cells, and other immune components, restoring Th1/Th2 balance, and repairing the nasal epithelial barrier through the delivery of molecules such as miR-143. Moreover, EVs, along with their associated proteins, microRNAs, and microbiome-derived information, hold promise as biomarkers for AR diagnosis, subtyping, and therapeutic efficacy prediction. Regarding treatment strategies, mesenchymal stem cell-derived EVs can enhance therapeutic outcomes via diverse administration routes and sustained-release hydrogel systems, and may also serve as carriers for antigens or drugs in combination with immunotherapy. Despite their potential, the clinical translation of EVs is confronted with many challenges, e.g., standardization of isolation methods, large-scale production, targeted delivery, and long-term safety. Future research should focus on engineering EVs, elucidating multi-omics mechanisms, and conducting rigorous clinical validation to facilitate their application in clinical practice.
