Soluble epoxide hydrolase:a next-generation drug target for Alzheimer's disease and related dementias

Alzheimer's disease(AD)and Alzheimer's diseaserelated dementias(ADRD)represent a significant public health challenge,with projections indicating a substantial increase in affected individuals due to the aging global population.From the World Health Organization,AD/ADRD has affected more than 55 million individuals worldwide,with an additional 10 million cases diagnosed each year.

Data-driven drug repositioning using olfactory omics profiles:challenges and perspectives in neurodegeneration

Data-driven drug repositioning using olfactory omics profiles-challenges and perspectives in neurodegeneration:Neurodegenerative diseases are characterized by progressive degeneration and loss of neuronal function in the central nervous system.These diseases are often characterized as proteinopathies,which are disorders primarily driven by the aggregation or misfolding of specific amyloid proteins within cells,leading to their dysfunction and eventual death.Despite the gain-of-function hypothesis related to the aggregation of these proteins,recently,an alternative hypothesis regarding the loss-of-function of the soluble monomeric proteins during the process of aggregation into amyloids is gaining currency.This last event is called proteinopenia and refers to conditions characterized by a deficiency or decrease in the levels of specific soluble proteins in the body(Ezzat et al.,2023).It has been demonstrated that levels of soluble proteins involved in neurodegenerative diseases are decreased.

Current status of drug therapy for chronic hepatitis B

In this editorial,we comment on the article by Meng et al.Chronic hepatitis B(CHB)is a significant global health problem,particularly in developing countries.Hepatitis B virus(HBV)infection is one of the most important risk factors for cirrhosis and hepatocellular carcinoma.Prevention and treatment of HBV are key measures to reduce complications.At present,drug therapy can effectively control virus replication and slow disease progression,but completely eliminating the virus remains a challenge.Anti-HBV treatment is a long-term process,and there are many kinds of antiviral drugs with different mechanisms of action,it is essential to evaluate the safety and efficacy of these drugs to reduce side effects and improve patients’compliance.We will summarize the current status of CHB drug treatment,hoping to provide a reference for the selection of clinical antiviral drugs.

Recognition and quality mapping of traditional herbal drugs:way forward towards artificial intelligence

The use of traditional herbal drugs derived from natural sources is on the rise due to their minimal side effects and numerous health benefits.However,a major limitation is the lack of standardized knowledge for identifying and mapping the quality of these herbal medicines.This article aims to provide practical insights into the application of artificial intelligence for quality-based commercialization of raw herbal drugs.It focuses on feature extraction methods,image processing techniques,and the preparation of herbal images for compatibility with machine learning models.The article discusses commonly used image processing tools such as normalization,slicing,cropping,and augmentation to prepare images for artificial intelligence-based models.It also provides an overview of global herbal image databases and the models employed for herbal plant/drug identification.Readers will gain a comprehensive understanding of the potential application of various machine learning models,including artificial neural networks and convolutional neural networks.The article delves into suitable validation parameters like true positive rates,accuracy,precision,and more for the development of artificial intelligence-based identification and authentication techniques for herbal drugs.This article offers valuable insights and a conclusive platform for the further exploration of artificial intelligence in the field of herbal drugs,paving the way for smarter identification and authentication methods.

Liposomes as versatile agents for the management of traumatic and nontraumatic central nervous system disorders:drug stability,targeting efficiency,and safety

Various nanoparticle-based drug delivery systems for the treatment of neurological disorders have been widely studied.However,their inability to cross the blood–brain barrier hampers the clinical translation of these therapeutic strategies.Liposomes are nanoparticles composed of lipid bilayers,which can effectively encapsulate drugs and improve drug delivery across the blood–brain barrier and into brain tissue through their targeting and permeability.Therefore,they can potentially treat traumatic and nontraumatic central nervous system diseases.In this review,we outlined the common properties and preparation methods of liposomes,including thin-film hydration,reverse-phase evaporation,solvent injection techniques,detergent removal methods,and microfluidics techniques.Afterwards,we comprehensively discussed the current applications of liposomes in central nervous system diseases,such as Alzheimer's disease,Parkinson's disease,Huntington's disease,amyotrophic lateral sclerosis,traumatic brain injury,spinal cord injury,and brain tumors.Most studies related to liposomes are still in the laboratory stage and have not yet entered clinical trials.Additionally,their application as drug delivery systems in clinical practice faces challenges such as drug stability,targeting efficiency,and safety.Therefore,we proposed development strategies related to liposomes to further promote their development in neurological disease research.

CKIP-1 siRNA影响膝关节骨性关节炎进展的动物实验研究

目的 探讨CKIP-1 siRNA对膝关节骨性关节炎进展的影响研究。方法 建立大鼠膝关节骨关节炎模型,选取其中一只分离培养实验大鼠骨髓间充质干细胞,分为空白组、阴性对照组和不同浓度的Ckip-1 siRNA组(10 pmol/ml、20 pmol/ml和50 pmol/ml)检测不同组的Ckip-1 siRNA表达量,确定最佳的Ckip-1 siRNA组为50 pmol/ml;将大鼠模型分为模型组20只、生理盐水组20只、CKIP-1 siRNA组20只,向生理盐水组注射生理盐水,向CKIP-1 siRNA组注射CKIP-1 siRNA干预的骨髓间充质干细胞,空白组不做处置。检测注射后的实验鼠膝关节处成骨相关基因OPN、Runx2的mRNA的相对表达量,检测其成骨能力变化情况。结果 检测注射后的实验鼠膝关节处成骨相关基因OPN、Runx2的mRNA的相对表达量明显增加(P<0.05),检测其成骨能力增强(P<0.05)。结论 Ckip-1基因对骨髓间充质干细胞的负调控作用。CKIP-1 siRNA干预后骨髓间充质干细胞能够增加实验鼠膝关节处骨再生能力,为膝关节骨性关节炎的治疗提供新的方法,期望能够提出新的靶点。

Design and preparation of a new multi-targeted drug delivery system using multifunctional nanoparticles for co-delivery of siRNA and paclitaxel

Drug resistance is a great challenge in cancer therapy using chemotherapeutic agents. Administration of these drugs with siRNA is an efficacious strategy in this battle. Here, the present study tried to incorporate siRNA and paclitaxel(PTX) simultaneously into a novel nanocarrier. The selectivity of carrier to target cancer tissues was optimized through conjugation of folic acid(FA) and glucose(Glu) onto its surface. The structure of nanocarrier was formed from ternary magnetic copolymers based on FeCopolyethyleneimine(FeCo-PEI) nanoparticles and polylactic acid-polyethylene glycol(PLA-PEG) gene delivery system. Biocompatibility of FeCo-PEI-PLA-PEG-FA(NPsA), FeCo-PEI-PLA-PEG-Glu(NPsB) and FeCo-PEI-PLA-PEG-FA/Glu(NPsAB) nanoparticles and also influence of PTX-loaded nanoparticles on in vitro cytotoxicity were examined using MTT assay. Besides, siRNA-FAM internalization was investigated by fluorescence microscopy. The results showed the blank nanoparticles were significantly less cytotoxic at various concentrations. Meanwhile, siRNA-FAM/PTX encapsulated nanoparticles exhibited significant anticancer activity against MCF-7 and BT-474 cell lines. NPsAB/siRNA/PTX nanoparticles showed greater effects on MCF-7 and BT-474 cells viability than NPsA/siRNA/PTX and NPsB/siRNA/PTX.Also, they induced significantly higher anticancer effects on cancer cells compared with NPsA/siRNA/PTX and NPsB/siRNA/PTX due to their multi-targeted properties using FA and Glu. We concluded that NPsAB nanoparticles have a great potential for co-delivery of both drugs and genes for use in gene therapy and chemotherapy.

Photostable and Biocompatible Fluorescent Silicon Nanoparticles for Imaging-Guided Co-Delivery of siRNA and Doxorubicin to Drug-Resistant Cancer Cells

The development of effective and safe vehicles to deliver small interfering RNA(siRNA) and chemotherapeutics remains a major challenge in RNA interference-based combination therapy with chemotherapeutics,which has emerged as a powerful platform to treat drug-resistant cancer cells.Herein,we describe the development of novel all-in-one fluorescent silicon nanoparticles(SiNPs)-based nanomedicine platform for imaging-guided co-delivery of siRNA and doxorubicin(DOX).This approach enhanced therapeutic efficacy in multidrug-resistant breast cancer cells(i.e.,MCF-7/ADR cells).Typically,the SiNP-based nanocarriers enhanced the stability of siRNA in a biological environment(i.e.,medium or RNase A) and imparted the responsive release behavior of siRNA,resulting in approximately 80% down-regulation of P-glycoprotein expression.Co-delivery of P-glycoprotein siRNA and DOX led to>35-fold decrease in the half maximal inhibitory concentration of DOX in comparison with free DOX,indicating the pronounced therapeutic efficiency of the resultant nanocomposites for drug-resistant breast cancer cells.The intracellular time-dependent release behaviors of siRNA and DOX were revealed through tracking the strong and stable fluorescence of SiNPs.These data provide valuable information for designing effective RNA interference-based co-delivery carriers.

Delivery systems for siRNA drug development in cancer therapy

Since the discovery of the Nobel prize-winning mechanism of RNA interference(RNAi)ten years ago,it has become a promising drug target for the treatment of multiple diseases,including cancer.There have already been some successful applications of siRNA drugs in the treatment of age-related macular degeneration and respiratory syncytial virus infection.However,significant barriers still exist on the road to clinical applications of siRNA drugs,including poor cellular uptake,instability under physiological conditions,off-target effects and possible immunogenicity.The successful application of siRNA for cancer therapy requires the development of clinically suitable,safe and effective drug delivery systems.Herein,we review the design criteria for siRNA delivery systems and potential siRNA drug delivery systems for cancer therapy,including chemical modifications,lipidbased nanovectors,polymer-mediated delivery systems,conjugate delivery systems,and others.

EXPERIMENTAL RESEARCH OF EFFECTIVENESS OF siRNA-Her-2/neu ON DRUG SENSITIVITY OF Her-2/neu-OVER-EXPRESSING LUNG ADENOCARCINOMA CELL LINE

Objective： Her-2/neu protein overexpression has been demonstrated in lung adenocarcinoma. Its overexpression often indicates a poor prognosis and resistance to chemotherapeutic agents. The objectives of this paper is to explore the effectiveness of double-stranded short inhibitory RNAs （siRNA） targeting Her-2/neu oncogene on the drug sensitivity of Her-2/neu-overexpressing lung adenocarcinoma cells. Methods： Lung adenocarcinoma cell line calu-3 was transfected with siRNAs formulated LipofectAMINE 2000, and Her-2/neu protein and P-gp were determined by flow cytometry （FCM）. The chemosensitivity of transfected cells to cisplatin （CDDP） was measured by MTT. Cell apoptosis detection kit （Annexin V method） was used to examine the drug induced apoptosis rate. Results： siRNA targeting Her-2/neu greatly reduced the cell surface expression of Her-2/neu protein and had no effect on P-gp. Consequently the inhibitory rate of CDDP in combination with siRNA targeting Her-2/neu was （67.1±2.3）%, while the inhibitory rates were （48.1±3.5）%, （46.3±5.9）% and （50.2±2.9）% in untreated control, empty vector and unrelated siRNA groups, respectively. The FCM results showed that the apoptosis rate of cells treated with CDDP combined with siRNAs-Her-2/neu was elevated when compared with unrelated siRNA group and empty vector group. Conclusion： Sequence specific siRNA targeting Her-2/neu was capable of enhancing the chemosensitivity of calu-3 cell to cisplatin.

Effect of Survivin-siRNA on Drug Sensitivity of Osteosarcoma Cell Line MG-63

Objective： Survivin is one of the apoptosis inhibitor genes and is rarely expressed in adult tissues. However, survivin expression has been detected in various human cancers and correlations have been recognized between the level of expression of this gene in tumors and prognosis. In this study, we investigated the effect of Survivin-siRNA on the drug sensitivity of osteosarcoma cell line MG-63. Methods： Two siRNAs （Survivin-siRNA1, Survivin-siRNA2） specifically targeting Survivin gene were chemically synthesized and transfected into MG-63 ceils. The Survivin mRNA level was detected by reverse transcription-polymerase chain reaction （RT-PCR）. The survivin protein expression and cell apoptosis rate were analyzed by flow cytometry （FCM）. The 50% inhibition concentration （IC50） of cisplatin （DDP） and adriamycin （ADM） on MG-63 cells was determined by MTT method. Results： Two short siRNA targeting survivin down-regulated the transcription of survivin gene dramatically and elevated apoptosis rate. They increased the drug sensitivity of MG-63 cells to ADM by five-fold and to DDP by nine-fold. Conclusion： Validated Survivin specific siRNA can effectively inhibit Survivin expression in survivin-overexpressing osteosarcoma MG-63 cell line and enhance the drug sensitivity of MG-63 cell line to ADM and DDP. Short survivin-siRNA mediated gene silencing may be a useful therapeutic strategy for osteosarcoma. These results suggest that survivin might be helpful for diagnosis of osteosarcoma and survivin siRNA combined with adriamycin or cisplatin may be a feasible strategy to enhance the effects of chemotherapy in patients with osteosarcoma.

Enhanced anticancer effect of doxorubicin by TPGS-coated liposomes with Bcl-2 siRNA-corona for dual suppression of drug resistance

Multiple drug resistance(MDR)is a tough problem in developing hepatocellular carcinoma(HCC)therapy.Here,we developed TPGS-coated cationic liposomes with Bcl-2 siRNA corona to load doxorubicin(Dox)i.e.,Bcl-2 siRNA/Dox-TPGS-LPs,to enhance anticancer effect of Dox in HCC-MDR.TPGS i.e.,d-α-tocopheryl polyethylene glycol 1000 succinate,inhibited Pglycoprotein(P-gp)efflux pump and Bcl-2 siRNA suppressed anti-apoptotic Bcl-2 protein.The Bcl-2 siRNA loaded in the liposomal corona was observed under transmission electron microscopy.The stability and hemolysis evaluation demonstrated Bcl-2 siRNA/Dox-TPGSLPs had good biocompatibility and siRNA-corona could protect the liposomal core to avoid the attachment of fetal bovine serum.In drug-resistant cells,TPGS effectively prolonged intracellular Dox retention time and siRNA-corona did improve the internalization of Dox from liposomes.In vitro and in vivo anticancer effect of this dual-functional nanostructure was examined in HCC-MDR Bel7402/5-FU tumor model.MTT assay confirmed the IC50 value of Dox was 20–50 fold higher in Bel7402/5-FU MDR cells than that in sensitive Bel7402 cells.Bcl-2 siRNA corona successfully entered the cytosol of Bel7402/5-FU MDR cells to downregulate Bcl-2 protein levels in vitro and in vivo.Bcl-2 siRNA/Dox-TPGS-LPs showed superior to TPGS-(or siRNA-)linked Dox liposomes in cell apoptosis and cytotoxicity assay in Bel7402/5-FU MDR cells,and 7-fold greater effect than free Dox in tumor growth inhibition of Bel7402/5-FU xenograft nude mice.In conclusion,TPGS-coated cationic liposomes with Bcl-2 siRNA corona had the capacity to inhibit MDR dual-pathways and subsequently improved the anti-tumor activity of the chemotherapeutic agent co-delivered to a level that cannot be achieved by inhibiting a MDR single way.

融合蛋白anti-EGFR-iRGD修饰的红细胞外囊泡联合siRNA靶向抑制三阴性乳腺癌恶性进程

目的:通过红细胞来源的细胞外囊泡(red blood cell-derived extracellular vesicles,RBCEVs)构建靶向递送系统以提高对三阴性乳腺癌(triple-negative breast cancer,TNBC)恶性进程的抑制效率。方法:采用脂质插入法将融合蛋白anti-抗人表皮生长因子受体(epidermal growth factor receptor,EGFR)-iRGD多肽结合至RBCEVs膜表面以构建生物相容性药物递送系统。通过电穿孔方式使连环蛋白β1(Catenin Beta 1,CTNNB1)-siRNA有效装载至anti-EGFR-iRGD-RBCEVs。进一步验证anti-EGFR-iRGD-si-CTNNB1-RBCEVs对TNBC增殖、迁移的影响及对上皮间充质转化相关蛋白表达的调控。结果:anti-EGFR-iRGD-si-CTNNB1-RBCEVs在120 h内具有较高血清稳定性,并且可有效防止RNA酶对CTNNB1-siRNA的降解。另外,该复合物可显著提高si-CTNNB1对TNBC细胞中CTNNB1基因及β-catenin蛋白的抑制作用并抑制TNBC细胞的增殖、迁移能力,下调Snail、Vimentin、N-cadherin并促进E-cadherin蛋白的表达。结论:该研究通过构建融合蛋白anti-EGFR-iRGD修饰的RBCEVs联合siRNA靶向抑制TNBC恶性进程,这将为治疗整合素α_(v)β_(3)高表达的TNBC提供更有利治疗方式。

Strategies for translating proteomics discoveries into drug discovery for dementia

Tauopathies,diseases characterized by neuropathological aggregates of tau including Alzheimer's disease and subtypes of fro ntotemporal dementia,make up the vast majority of dementia cases.Although there have been recent developments in tauopathy biomarkers and disease-modifying treatments,ongoing progress is required to ensure these are effective,economical,and accessible for the globally ageing population.As such,continued identification of new potential drug targets and biomarkers is critical."Big data"studies,such as proteomics,can generate information on thousands of possible new targets for dementia diagnostics and therapeutics,but currently remain underutilized due to the lack of a clear process by which targets are selected for future drug development.In this review,we discuss current tauopathy biomarkers and therapeutics,and highlight areas in need of improvement,particularly when addressing the needs of frail,comorbid and cognitively impaired populations.We highlight biomarkers which have been developed from proteomic data,and outline possible future directions in this field.We propose new criteria by which potential targets in proteomics studies can be objectively ranked as favorable for drug development,and demonstrate its application to our group's recent tau interactome dataset as an example.

纳米凝胶搭载的siRNA通过靶向抑制施万细胞铁死亡促进周围神经损伤修复

目的:探究周围神经损伤(PNI)后施万细胞的死亡机制,使用纳米凝胶搭载的siRNA靶向抑制施万细胞死亡。方法:下载GEO数据库中PNI的转录组数据,依次进行数据处理、差异分析、GO功能富集分析、铁死亡通路鉴定以及靶基因的筛选。通过蛋白印记和qPCR实验验证靶基因的差异性。自组装单宁酸(TA)-siRNA纳米凝胶,通过丁达尔效应实验、粒径和电位测量、细胞吞噬实验、细胞骨架染色和CCK-8细胞活力实验鉴定纳米凝胶的物理学和生物学特性。通过划痕实验、免疫荧光染色实验、蛋白印记和qPCR实验验证TA-siRNA纳米凝胶抑制施万细胞铁死亡的有效性。结果:PNI后施万细胞出现明显的铁死亡现象,Bex1是调控施万细胞铁死亡的关键基因。TA-siRNA纳米凝胶具有优良的物理学和生物学特性,能够将siRNA成功地携带到损伤的施万细胞中并沉默靶基因,从而有效地抑制施万细胞损伤后的铁死亡。结论:纳米凝胶搭载的siRNA可以靶向抑制施万细胞铁死亡,为临床治疗PNI提供新的方向。

创面siRNA敲降HO-1改善小鼠放创复合伤创面愈合的实验研究

目的检测血红素加氧酶1(heme oxygenase-1,HO-1)在放创复合伤(radiation-wound combined injury,R-W-CI)创面修复中的表达情况,评价通过siRNA敲降HO-1对放创复合伤创面愈合的改善作用。方法将36只8周龄雄性C57BL/6J小鼠按随机数字表法分为单纯皮肤创伤组(W组,n=18)和合并全身辐射(6 Gy)损伤的皮肤创伤组(R-W-CI组,n=18),建立单纯皮肤创伤与放创复合伤的小鼠模型。在创面愈合过程中,拍照记录创面愈合情况并通过Image J量化分析残留面积;取材创面组织进行HE染色及病理组织学观察;动态检测外周血象评估造血系统损伤情况。通过创面组织定量PCR及Western blot检测创面HO-1表达水平及变化情况。将26只8周龄雄性C57BL/6J小鼠随机分为siRNA敲降HO-1组(si-HO-1组,n=13)和siRNA阴性对照组(si-NC组,n=13)。放创复合伤致伤后,si-HO-1组在每个创面涂抹负载si-HO-1(5μmol/L)的F127凝胶60μL,si-NC组创面涂抹等量负载阴性对照si-NC的F127凝胶。通过创面组织Western blot检测HO-1的敲降情况,观察创面面积变化,对伤后第3天样本进行定量PCR检测IL-1β、IL-6、TNF-α等炎症因子的表达变化,组织切片进行Ki67免疫组织化学和HE染色;对第9天创面组织进行HE染色病理评估;综合评价敲降HO-1对放创复合伤创面愈合的改善作用。结果与W组相比,创面残留面积的半定量分析表明R-W-CI组愈合在伤后第7、10天显著延迟(P<0.01);第7天的HE病理显示R-W-CI组再上皮化延缓,肉芽组织生长不良;同时R-W-CI组外周血白细胞及其分类计数显示在损伤后早期即显著下降(P<0.05)。检测发现,R-W-CI组创面HO-1蛋白在伤后第3、7天表达略高于W组,但无显著差异(P>0.05),而在第10天显著升高(P<0.05),同时伴有全长与截短形式的分布改变;定量PCR显示R-W-CI组在伤后第7天、10天的创面组织HO-1的表达显著高于W组(P<0.05)。放创复合伤创面siRNA干预实验显示:与si-NC组比较,si-HO-1组能有效敲降创面HO-1蛋白含量(P<0.05),促进伤口收缩(P<0.05),减小创面宽度(P<0.01),上调致伤第3天创面IL-6、TNF-α等炎症因子表达,促进创缘组织细胞增殖,改善肉芽组织生长情况。结论放创复合伤创面修复过程中存在HO-1蛋白的持续高表达,创面siRNA敲降HO-1可以改善R-W-CI组小鼠创面乏炎状态,促进创面愈合。

Peptide drugs: a new direction in cancer immunotherapy

Cancer immunotherapy has emerged as a promising approach in cancer treatment and is considered a major advancement after surgical interventions, radiotherapy, chemotherapy, and targeted therapy. The clinical use of immunotherapeutic drugs, particularly antibody-based drugs that target immune checkpoints, has notably increased~1.

Microglia in drug addiction:A perspective from neuroimmunopharmacology

Drug addiction refers to a state of dependence that arises from habitual drug intake and can result in specific withdrawal symptoms upon cessation.The most commonly abused substances include psychostimulants,cannabinoids,and opioids.When drugs are consumed,they stimulate the release of dopamine,a neurotransmitter crucial for the pleasure and reward centers of the brain.With repeated drug use,the brain undergoes various changes,leading to tolerance,dependence,and addiction(Lüscher et al.,2020).The mechanisms involved in drug addiction are highly complex and involve diverse cell types within the brain.

Chinese expert consensus on the clinical application of drugcoated balloon(2^(nd) Edition)

Percutaneous coronary interventions have progressed through the era of plain balloon dilation, bare-metal stent insertion to drug-eluting stent treatment, which has significantly reduced the acute occlusion and restenosis rates of target vessels and improved patient prognosis, making drug-eluting stents the mainstream interventional treatment for coronary artery disease. In recent years, drug-coated balloons(DCBs) have become a new treatment strategy for coronary artery disease, and the drugs used in the coating and the coating technology have progressed in the past years. Without permanent implant, a DCB delivers antiproliferative drugs rapidly and uniformly into the vessel wall via the excipient during a single balloon dilation. Many evidence suggests that DCB angioplasty is an effective measure for dealing with in-stent restenosis and de novo lesions in small coronary vessels.As more clinical studies are published, new evidence is emerging for the use of DCB angioplasty in a wide range of coronary diseases, and the indications are expanding internationally. Based on the latest research from China and elsewhere, the Expert Writing Committee of the Chinese Expert Consensus on Clinical Applications of Drug-Coated Balloon has updated the previous DCB consensus after evidence-based discussions and meetings in terms of adequate preparation of in-stent restenosis lesions, expansion of the indications for coronary de novo lesions, and precise guidance of DCB treatment by intravascular imaging and functional evaluation.

Extracellular vesicles in anti-tumor drug resistance: Mechanisms and therapeutic prospects

Drug resistance presents a significant challenge to achieving positive clinical outcomes in anti-tumor therapy.Prior research has illuminated reasons behind drug resistance,including increased drug efflux,alterations in drug targets,and abnormal activation of oncogenic pathways.However,there's a need for deeper investigation into the impact of drug-resistant cells on parental tumor cells and intricate crosstalk between tumor cells and the malignant tumor microenvironment(TME).Recent studies on extracellular vesicles(EVs)have provided valuable insights.EVs are membrane-bound particles secreted by all cells,mediating cell-to-cell communication.They contain functional cargoes like DNA,RNA,lipids,proteins,and metabolites from mother cells,delivered to other cells.Notably,EVs are increasingly recognized as regulators in the resistance to anti-cancer drugs.This review aims to summarize the mechanisms of EV-mediated anti-tumor drug resistance,covering therapeutic approaches like chemo-therapy,targeted therapy,immunotherapy and even radiotherapy.Detecting Ev-based biomarkers to predict drug resistance assists in bypassing anti-tumor drug resistance.Additionally,targeted inhibition of EV biogenesis and secretion emerges as a promising approach to counter drug resistance.We highlight the importance of conducting in-depth mechanistic research on EVs,their cargoes,and functional ap-proaches specifically focusing on EV subpopulations.These efforts will significantly advance the devel-opment of strategies to overcome drug resistance in anti-tumor therapy.