Role of extracellular vesicle–mediated neurodegeneration in substance use disorders

Substance use disorders (SUDs) remain a complicated and widespread public health problem, characterized by obsessive drug and alcohol use, despite adverse consequences. Emerging research suggests that the extracellular vesicles (EVs) play a critical role in mediating drug addiction and several neurodegenerative processes associated with SUDs. EVs, which include exosomes, microvesicles, and apoptotic bodies, are lipid-bilayered vesicles that facilitate intracellular communication throughout the host by shuttling bioactive molecules, such as proteins, lipids, DNA fragments, and RNA, including both coding and noncoding RNAs across recipient cells. The current review is a comprehensive analysis highlighting the potential role of EVs in the onset and progression of SUD, specifically in the context of cocaine, cannabis, methamphetamine, opiates, alcohol, and tobacco. The goal is to offer valuable insights into the underlying mechanism(s) involving EVs in the pathogenesis of SUD, ultimately paving the way for new therapeutic avenues.