Using bibliometric analysis, the authors evaluated 752 peer-reviewed publications published between 2014 and 2024, mapping global research output, collaboration networks and thematic trends. The analysis showed a steady rise in publication volume, with China and the United States leading in research activity. Major research clusters focused on engineered EVs, drug delivery platforms and regenerative mechanisms including angiogenesis, bone regeneration and immunomodulation.  

MSC-derived EVs are highlighted as a promising cell-free regenerative approach, capable of delivering biologically active cargo such as microRNAs, cytokines and growth factors. By influencing cellular signalling rather than relying on direct cell engraftment, EVs are positioned as a potential alternative to whole-cell therapies in tissue engineering and regenerative medicine.  

However, the review emphasises several unresolved challenges. These include limited efficiency of passive targeting, difficulties in controlling EV cargo loading, lack of standardised isolation and characterisation methods, and a fragmented and rapidly expanding evidence base that complicates comparison across studies. The authors note that these factors continue to constrain reproducibility and clinical scalability.