The Application of Exosomes in the Diagnosis of Parkinson’s Disease: Potentials and Challenges of Biomarkers

Parkinson’s disease (PD), the second most common neurodegenerative disorder, is characterized by the progressive loss of dopaminergic neurons and abnormal aggregation of α-synuclein (α-syn). In recent years, exosomes have emerged as crucial mediators of intercellular communication, attracting significant attention for their potential in PD diagnosis and therapy due to their ability to cross the blood-brain barrier (BBB), low immunogenicity, and high biocompatibility. This review comprehensively summarizes the role of exosomes in the pathogenesis of PD, focusing on their involvement in α-syn propagation, modulation of neuroinflammation, and delivery of non-coding RNAs. Furthermore, the diagnostic value of exosomes as biomarkers and their application as drug delivery vehicles are critically evaluated. The latest advances in exosome-based therapeutic strategies for PD are discussed, alongside the existing challenges and future directions in this rapidly evolving field. By providing an integrated perspective on the mechanisms and applications of exosomes in PD, this review aims to offer a theoretical foundation and guide further research toward precision diagnosis and treatment of PD.