Background. Schizophrenia, as a chronic and debilitating mental illness, often results in a decrease in the quality of life of patients. This systematic review aimed to investigate blood and brain exosomes as biomarkers for the diagnosis of schizophrenia. Methods. In this systematic review, articles on the role of exosomes and their molecular content in patients with schizophrenia were identified by searching PubMed, Scopus, Embase, and Web of Science databases up to July 2025. Results. A total of 215 articles were reviewed, and 19 studies were selected for inclusion. Our findings revealed that the molecular content of exosomes, including proteins, metabolites, and circRNA, differs significantly between individuals with schizophrenia and healthy controls. These biomarkers are associated with key pathophysiological signaling pathways, including neurotransmission, mitochondrial processes, neuroinflammation, and metabolism. Conclusion. The use of exosomes as biomarkers can enhance diagnostic accuracy and provide better insight into the molecular mechanisms involved in the development and manifestation of schizophrenia. Practical Implications. Exosomes can be used as biomarkers for the diagnosis of schizophrenia. They have the potential to serve as non-invasive tools for the diagnosis of schizophrenia, assessment of response to treatment, and development of targeted therapies for this mental disease. The findings of the present study provide a new perspective for the personalization of therapy for individuals with schizophrenia and the early treatment of these patients.
Shafiee-Kandjani et al. (Sun,) studied this question.
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