Therapeutic Potential of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Digestive System Tumors: Modulating the Chronic Inflammatory Microenvironment

Digestive system tumors (including colorectal cancer, hepatocellular carcinoma, and gastric cancer) have become one of the most serious global cancer burdens, and their pathological evolution and chronic inflammatory microenvironments are closely related. Chronic inflammation moves into cancer by angling immune cell infiltration, pro-inflammatory stuff, and aberrant signaling pathways, which advance tumor cell growth factor and burst, hitching a ride. In this context, mesenchymal stem cell-derived extracellular vesicles (MSC-EVs)—naturally occurring nan vesicles enveloped by a bilipidic layer—are loaded with bioactive substances like proteins, miRNAs, which present considerable promise in remodeling the chronic inflammatory microenvironments and arresting tumor development. MSC - EVs have the benefits of low risk of being immunogenic, good biological compatibility, and targeted homing capabilities; however, the main aspect is that they adjust immune cells and interfere with key signaling systems using the bioactive materials that they carry. This can be carried out to modulate the chronic inflammatory environment, and it is also carriers to carry specific loads (miRNAs, chemotherapeutic drugs, etc.) to inhibit the tumor cell biological behavior. However, the potential pro-tumorigenic effects of MSC-EVs under specific conditions cannot be overlooked, as they may also transport cargos that accelerate tumor progression. Similarly, EVs derived from non-mesenchymal sources have been shown to drive malignancy through various signaling mechanisms. Although MSC-EVs have great clinical value, there are still problems such as the standardization of preparation, the standardization of heterogeneity control, and the standardization of safety evaluation. Current engineering modification strategies can enhance the effectiveness of engineering. In the future, innovative combinations of technologies and approaches may even lead to more rapid progress toward translation from the bench to the bedside. This paper mainly discusses MSC-EVs regulation mechanism towards chronic inflammation, and the potential for it to inhibit or promote tumor growth, as well as conducting a systematic review of current research on MSC-EVs as a treatment agent for digestive system tumors. Finally, It outlines challenges in clinical application and future prospects.