Research advances in microneedle-exosome delivery systems for the treatment of multisystem diseases.

The combined application of microneedles (MNs) and exosomes represents a significant research direction in the fields of targeted drug delivery and regenerative medicine. Their synergistic and complementary effects not only address key technical challenges associated with exosome delivery-such as low delivery efficiency and limited tissue penetration-but also endow MNs with capabilities for targeted therapy and precise diagnostics, thereby demonstrating substantial advantages in the diagnosis and treatment of multisystem diseases. This review summarizes recent advances in MN-exosome delivery systems across dermatological, cardiovascular and cerebrovascular, and musculoskeletal diseases, as well as tumor diagnosis and therapy, ocular surface disorders, and oral diseases. It focuses on the fabrication strategies, mechanisms of action, and therapeutic efficacy of various MN-based exosome delivery systems. Furthermore, it proposes research perspectives and potential solutions for diseases that respond poorly to conventional diagnostic and therapeutic approaches, providing a reference for the future development and clinical translation of MN-exosome systems.