Plant-Derived Extracellular Vesicles for Nanomedicine in Cardiopulmonary Diseases: A Narrative Review.

This narrative review summarizes research progress on plant-derived extracellular vesicles (PEVs) for nanomedicine in cardiopulmonary system diseases, based on key literature covering isolation, engineering, and disease mechanisms. PEVs possess high biocompatibility, low immunogenicity, broad source availability, and scalability. Their bioactive cargo (proteins, nucleic acids, lipids, secondary metabolites) regulates inflammation, oxidative stress, apoptosis, and fibrosis. This review systematically discusses PEV characteristics, large-scale isolation, and engineering approaches, with a focus on multi-target and cell-specific mechanisms in atherosclerosis, myocardial infarction, COPD, and pulmonary fibrosis. Although challenges in standardization, in vivo mechanisms, and translation remain, engineered PEVs hold promise as efficient and safe nanomedicines. The unique contribution of this review is to integrate PEV preparation and engineering with their disease-specific mechanisms, providing a coherent framework for future translational research in cardiopulmonary nanomedicine.