Narrative review explores plant-derived extracellular vesicles for rheumatoid arthritis

This narrative review examines the therapeutic potential of plant-derived extracellular vesicles (PDEVs) for rheumatoid arthritis (RA), based on preclinical studies. The authors synthesize evidence that PDEVs can modulate immune responses, suppress inflammatory pathways, exert antioxidant effects, protect bone and cartilage, and influence the gut-joint axis. These mechanisms suggest PDEVs may offer a novel approach to RA treatment, but the review emphasizes that the majority of studies have been conducted in cell culture or animal models, and clinical data remain unavailable.

Key limitations identified include insufficient standardization of isolation protocols, product heterogeneity across different plant sources, and limited mechanistic insight into how PDEVs exert their effects. The review notes favorable biocompatibility as a potential advantage, but no adverse events or safety data from human studies are reported.

Given the preclinical nature of the evidence, the findings should be considered exploratory. The authors do not provide pooled effect sizes or quantitative synthesis, as this is a narrative review. Practice relevance is not directly addressed, but the review highlights the need for standardized production methods and rigorous clinical trials before PDEVs can be considered for RA management.