Exosome-Based Vaccines: Pioneering New Frontiers in Combating Infectious Diseases and Cancer

Exosomes, small extracellular vesicles with lipid bilayer membranes, play a crucial role in cellular communication and can transfer diverse biological cargo, including proteins, lipids, and nucleic acids, from donor to recipient cells. Exosomes possess diverse immunological properties, such as antigen delivery and immune activation, along with excellent drug delivery capabilities, making them promising candidates for vaccine development. For different diseases, exosome-based vaccines can be designed as therapeutic or prophylactic vaccines by leveraging cellular immunity or humoral immunity. With the emergence of precision medicine, exosome-based personalized vaccines demonstrate exceptional therapeutic potential. This review systematically introduces the sources, biogenesis mechanisms, and components of exosomes and describes their regulatory roles in the immune system. Subsequently, the preparation, administration, and personalized therapy of exosome-based vaccines are discussed. Finally, the applications and clinical trials of exosome-based vaccines in the fields of anti-infection and anti-tumor therapies are particularly highlighted, with an analysis of the potential challenges in future vaccine development.