• Exosomes can cross the blood-brain barrier and deliver miRNAs to regulate neuroinflammation and pain signaling, offering high biocompatibility and low immunogenicity.
• Engineered delivery systems such as hydrogels, gelatin sponges, and DNA nanostructures enable precise and sustained release of exosomes at injury sites.
• Exosomes from mesenchymal stem cells and other sources improve nerve conduction, repair nerve fibers, alleviate pain, and promote neurovascular remodeling.
• Bibliometric analysis reveals that the United States and China lead research, with key hotspots including nerve regeneration, neuroinflammation, and spinal cord injury.