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REVIEW
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Engineering strategies and biomedical applications of bacterial extracellular vesicles

Xuying Liang1# ,  Qianbei Li1# ,  Lei Zheng1* ,  Bo Situ1*
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1 Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
BMT 2025 , 6(3), 265–280; https://doi.org/10.12336/bmt.24.00032
Submitted: 7 June 2024 | Revised: 27 July 2024 | Accepted: 5 September 2024 | Published: 22 September 2025
Copyright © 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution–NonCommercial–ShareAlike 4.0 License.
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Abstract

Bacterial extracellular vesicles (BEVs) are emerging as promising therapeutic agents and drug delivery vehicles due to their unique properties. These nanoscale vesicles possess stable membrane structure and naturally encapsulate a variety of bioactive molecules, making them versatile tools in biomedical applications. However, clinical translation of BEVs faces challenges such as insufficient display of disease-specific antigens, excessive toxicity, and rapid clearance. Addressing these issues is crucial for the clinical translation of BEVs. In this review, we discuss recent advances in BEV engineering strategies aimed at addressing these limitations and expanding their therapeutic applications. We highlight approaches for loading exogenous cargo into BEVs, detoxification strategies, and the latest progress in the application of engineered BEVs for treating infectious diseases, cancer, and other disorders. Despite promising preclinical results, clinical translation is hindered by safety concerns, standardisation difficulties, and scalability issues. Future research should focus on optimising detoxification processes, establishing global standardisation, and improving production methods to facilitate successful clinical translation of engineered BEVs. This review provides insights into the current status and future perspectives of BEV engineering for therapeutic applications.

Keywords
Bacterial extracellular vesicles
Disease treatment
Engineering
Vaccine
Funding
This work was supported by Guangdong Natural Science Fund for Distinguished Young Scholars (No. 2023B1515020058); the National Natural Science Foundation of China (No. 82272438); the Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University (No. 2022J001); Science and Technology Projects in Guangzhou (No. 2024A04J9987); the Open Research Funds from the Qingyuan People’s Hospital, Guangzhou Medical University (No. 202301-202).
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Conflict of interest
All authors declare no competing interests.
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