The regulatory effects of extracellular vesicles derived from adipose stem cells on tumor biological activity.

The field of malignant tumor diagnosis and treatment urgently requires innovative research perspectives to overcome the existing limitations. Extracellular vesicles (EVs) are crucial mediators of intercellular communication, offering novel avenues for regulating tumors. Among these, extracellular vesicles derived from adipose-derived stem cells (ADSC-EVs) have garnered significant attention because of their exceptional stability, safety profile, and ease of storage and transportation. Here, we first elucidate the biological foundation of ADSC-EVs, delineating their biogenesis pathway characterized by the "early endosome-multivesicular body-extracellular release" process, and highlight the heterogeneity of their molecular cargo. This cargo includes 148 regulatory microRNAs (such as the let-7 family and miR-122), 1,466 functional proteins, and various lipid molecules, thereby underpinning its multifunctional regulatory potential. Mechanistically, the dual role of ADSC-EVs is emphasized: on one hand, they can activate signaling pathways, such as PI3K/AKT, or modulate metabolic reprogramming to promote tumor proliferation; on the other hand, they exert tumor-suppressive effects by delivering specific microRNAs (e.g., miR-503-3p) and remodeling the tumor immune microenvironment to influence tumor progression. From an application standpoint, the tripartite value of ADSC-EVs is underscored: serving as potential biomarkers to assist in tumor diagnosis and classification, enabling targeted delivery of anticancer agents following engineering modifications, and functioning as acellular tools that circumvent the risks associated with conventional stem cell therapies. In summary, this study constructed a comprehensive framework for the application of ADSC-EVs in tumor diagnosis and treatment, providing both theoretical and practical support for overcoming therapeutic bottlenecks and developing precision strategies.