Advancements in extracellular vesicle targeted therapies for rheumatoid arthritis: insights into cellular origins, current perspectives, and emerging challenges

• Extracellular vesicles (EVs) offer a promising targeted therapy for rheumatoid arthritis by modulating immune responses and delivering anti-inflammatory agents directly to affected joints. • The therapeutic potential of EVs in RA depends on their cellular source and cargo, with both pro-inflammatory and anti-inflammatory effects observed. • Current challenges include lack of standardized protocols for EV isolation, characterization, and delivery, hindering clinical translation. • This review provides a comprehensive overview of EV-based therapies for RA, highlighting future directions and emerging challenges.