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REVIEW article
Front. Immunol.
Sec. Vaccines and Molecular Therapeutics
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1454306
EXTRACELLULAR VESICLES AS PRECISION THERAPEUTICS FOR PSYCHIATRIC CONDITIONS: TARGETING INTERACTIONS AMONG NEURONAL, GLIAL, AND IMMUNE NETWORKS
Provisionally accepted
Ivana Kawikova 1*
Vaclav Spicka 2
James C K Lai 3
Ing Zdenek Kejik 4
Ing Milan Jakubek 4 Karel Vales 5 Filip Spaniel 6- 1 School of Medicine, Yale University, New Haven, Connecticut, United States
- 2 Academy of Sciences of the Czech Republic (ASCR), Prague, Prague, Czechia
- 3 Yale University, New Haven, Connecticut, United States
- 4 First Faculty of Medicine, Charles University, Prague, Prague, Czechia
- 5 Third Faculty of Medicine, Charles University, Prague, Prague, Czechia
- 6 National Institute of Mental Health (Czechia), Prague, Prague, Czechia
The critical role of the immune system in brain function and dysfunction is well recognized, yet development of immune therapies for psychiatric diseases has been slow due to concerns about iatrogenic immune deficiencies. These concerns are emphasized by the lack of objective diagnostic tools in psychiatry. A promise to resolve this conundrum lies in the exploitation of extracellular vesicles (EVs) that are physiologically produced or can be synthetized. EVs regulate recipient cell functions and offer potential for EVs-based therapies. Intranasal EVs administration enables the targeting of specific brain regions and functions, thereby facilitating the design of precise treatments for psychiatric diseases.The development of such therapies requires navigating four dynamically interacting networks: neuronal, glial, immune, and EVs. These networks are profoundly influenced by brain fluid distribution, which are crucial for homeostasis, cellular functions, and intercellular communication.Fluid abnormalities, like edema or altered cerebrospinal fluid (CSF) dynamics, disrupt these networks, thereby negatively impacting brain health.A deeper understanding of the above-mentioned four dynamically interacting networks is vital for creating diagnostic biomarker panels to identify distinct patient subsets with similar neurobehavioral symptoms. Testing the functional pathways of these biomarkers could lead to new therapeutic tools. Regulatory approval will depend on robust preclinical data reflecting progress in these interdisciplinary areas, which could pave the way for the design of innovative and precise treatments. Highly collaborative interdisciplinary teams will be needed to achieve these ambitious goals.
Keywords: extracellular vesicles, Immune System, Neurological and Psychiatric Disorders, extracellular vesicle-based therapies, regulatory agencies, pharmacokinetics, Pharmacodynamics
Received: 24 Jun 2024; Accepted: 14 Feb 2025.
Copyright: © 2025 Kawikova, Spicka, Lai, Kejik, Jakubek, Vales and Spaniel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ivana Kawikova, School of Medicine, Yale University, New Haven, 06510, Connecticut, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.