Preclinical evaluation reveals that aerosol-resilient EV-liposome hybrids improve inhaled nintedanib delivery in pulmonary fibrosis, indicating a practical strategy for inhaled nanomedicine.
Extracellular vesicles (EVs) are promising biomimetic nanocarriers for pulmonary delivery, but their inhalation translation is limited by membrane fragility under aerosol-induced shear and air-liquid interfacial stress. Here, we developed an EV-liposome hybrid vesicle formulation (NIN@SV) for inhalable delivery of nintedanib and identified a composition-dependent balance between EV-derived biological functionality and aerosol robustness. An optimized EV protein:NIN@LP lipid mass ratio of 3:7 enhanced mucus penetration and cellular association while minimizing post-nebulization size drift and preserving aerodynamic performance. Density-gradient fractionation and physical-mixture controls supported the formation of a hybrid vesicle-enriched population rather than simple coexistence of unfused EVs and liposomes. In parallel, FRET-assisted membrane-proximity analysis, calibrated using disruption controls, indicated improved resistance of NIN@SV to aerosol-induced membrane perturbation. Functionally, NIN@SV enhanced formulation-associated cellular association, prolonged pulmonary retention, and attenuated bleomycin-induced pulmonary fibrosis under the tested nominal inhaled dosing regimen. Mechanistically, NIN@SV suppressed fibroblast activation and attenuated pro-fibrotic macrophage-associated features. Together, these findings support an aerosol-resilient EV-liposome membrane-engineering strategy and provide a practical design rationale for inhalable hybrid vesicles in pulmonary drug delivery.
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Yan et al. (2026) studied this question.
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