Therapeutic Applications of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Diabetic Neuropathy; Challenges and Future Prospective.

Diabetes, a collection of metabolic syndromes, is a significant global health issue. One of the most prevalent microvascular complications of diabetes that is linked to excessive blood sugar levels is diabetic neuropathy (DN). DN frequently necessitates prolonged therapy and may persist following treatment, which could have a negative impact on the individual's quality of life. The crucial management of DN still requires the development of efficient therapies, regardless of the continuous discovery of new drugs. A novel innovation and advancement in the treatment of diabetes and diabetes-related complications has been the emergence of mesenchymal stem cells (MSCs). Compared to their parent donors, MSC-derived extracellular vesicles (MSC-EVs) have shown considerable potential as a unique cell-free method that reprograms damaged cells by initiating regenerative processes. Increasingly, research has demonstrated that MSC-EVs transfer a variety of biological compounds to establish a beneficial microenvironment, thereby playing an important role in alleviating diabetic complications. The objective of this review was to offer a comprehensive perspective on the utilization of MSC-derived EVs in DN, as well as to discuss recent developments and potential challenges to improve their efficacy in DN.