Targeted Delivery of Cardiovascular Drugs Using Exosome-Mimetic Nanocarriers

Background: Precision drug delivery to cardiovascular tissues remains a critical challenge due to systemic off-target effects, rapid clearance, and limited tissue specificity of conventional therapeutics. Exosome-mimetic nanocarriers have emerged as an innovative platform for targeted cardiovascular drug delivery, leveraging the intrinsic biocompatibility, nanoscale size, and cellular tropism of natural extracellular vesicles. These engineered vesicles are designed to replicate the surface markers and membrane architecture of native exosomes, allowing for efficient cargo loading, prolonged circulation, and selective uptake by cardiac and vascular cells. Methods and Results: This review synthesizes recent advances in the design, fabrication, and preclinical evaluation of exosome-mimetic nanocarriers for cardiovascular applications. Methods of production include top-down extrusion from donor cells, bottom-up synthetic assembly, and hybrid approaches integrating liposomes with membrane proteins. These nanocarriers have been successfully loaded with a variety of cardiovascular agents, including anti-inflammatory drugs, RNA therapeutics, nitric oxide donors, and anti-fibrotic compounds. In preclinical models of myocardial infarction, pulmonary hypertension, and atherosclerosis, targeted delivery using exosome-mimetics has resulted in enhanced drug accumulation in diseased tissues, reduced systemic toxicity, and improved functional outcomes. Mechanistic studies reveal receptor-mediated uptake via integrins, tetraspanins, and lectins as key pathways for cellular targeting. Surface modification with peptides or antibodies further enhances tissue specificity and therapeutic index. Conclusion: Exosome-mimetic nanocarriers represent a promising frontier in cardiovascular nanomedicine, offering a customizable and biologically inspired approach to precision drug delivery. As bioengineering and translational efforts advance.