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Abstract
During the last decade, the fields of advanced and personalized therapeutics have
been constantly evolving, utilizing novel techniques such as gene editing and RNA
therapeutic approaches. However, the method of delivery and tissue specificity remain
the main hurdles of these approaches. Exosomes are natural carriers of functional
small RNAs and proteins, representing an area of increasing interest in the field
of drug delivery. It has been demonstrated that the exosome cargo, especially miRNAs,
is at least partially responsible for the therapeutic effects of exosomes. Exosomes
deliver their luminal content to the recipient cells and can be used as vesicles for
the therapeutic delivery of RNAs and proteins. Synthetic therapeutic drugs can also
be encapsulated into exosomes as they have a hydrophilic core, which makes them suitable
to carry water-soluble drugs. In addition, engineered exosomes can display a variety
of surface molecules, such as peptides, to target specific cells in tissues. The exosome
properties present an added advantage to the targeted delivery of therapeutics, leading
to increased efficacy and minimizing the adverse side effects. Furthermore, exosomes
are natural nanoparticles found in all cell types and as a result, they do not elicit
an immune response when administered. Exosomes have also demonstrated decreased long-term
accumulation in tissues and organs and thus carry a low risk of systemic toxicity.
This review aims to discuss all the advances in exosome therapies in ophthalmology
and to give insight into the challenges that would need to be overcome before exosome
therapies can be translated into clinical practice.