Exosomes: Roles and Therapeutic Potential in Pain.

Pain is a signal that the human body is being damaged or attacked by disease. It significantly impacts quality of life and imposes a substantial economic burden. Current analgesic drugs fail to meet clinical application standards due to limited choice, inadequate efficacy, and side effects. Consequently, the development of new treatment strategies for pain relief is essential. Pain signals are conveyed by nociceptors via the central nervous system to the brain, with cell-to-cell communication serving as a crucial step in the sensory nociceptive process. Exosomes are extracellular vesicles involved in intercellular communication, capable of transporting and delivering biological macromolecules. Growing evidence suggests that exosomes contribute significantly to the pathological processes associated with pain-related diseases. Summarizing the characteristics of exosomes and their molecular cargo under various pain conditions, along with identifying specific exosomal signatures, is essential for the early diagnosis and treatment of such diseases. This review systematically elucidates the molecular and cellular mechanisms of exosomes in pain relief and evaluates their potential therapeutic value in pain management. We aim to deepen the understanding of exosome-pain interactions, thereby laying the foundation for developing novel and promising therapeutic strategies. Furthermore, we scrutinize the current status of clinical research on exosome-mediated analgesia and dissect the prevailing technical challenges and future research directions. Our objective is to provide clear scientific guidance and a theoretical basis to facilitate the clinical translation of exosome therapies.