A Review of Mesenchymal Stem Cell-Derived Extracellular Vesicles: New Opportunities for Regenerative Medicine in Neurological Disorders

Extracellular vesicles produced by mesenchymal stem cells (MSC-EVs), including exosomes, microvesicles, and apoptotic bodies, are key mediators of intercellular communication and have attracted increasing attention in recent years as potential therapeutic agents for neurological disorders. Predominantly preclinical investigations, including in vitro and animal model studies, demonstrate that MSC-EVs can enhance axonal growth, promote regeneration of nerve fibers and remyelination, and modulate inflammatory processes in injured nervous tissue. These effects have been observed across multiple neurological conditions, including spinal cord injury, traumatic brain injury, ischemic stroke, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis, though primarily in experimental settings. Owing to their ability to carry biologically active molecules and to cross the blood–brain barrier, MSC-EVs have shown potential as vehicles for targeted delivery of therapeutic molecules to the central nervous system. However, the overwhelming majority of evidence remains preclinical, and clinical translation is limited by the scarcity of completed, rigorously controlled human trials. To advance toward clinical application, further research is required to standardize methods for vesicle isolation, characterization, and delivery, establish optimal dosing regimens, and develop robust quality control standards. A more comprehensive understanding of MSC-EVs signaling mechanisms may facilitate the future development of therapeutic strategies, contingent upon rigorous validation in well-designed clinical studies.