细胞源性小型胞外囊泡——外泌体，通过相互转运DNA、RNA、生物活性蛋白、葡萄糖链和代谢物，在细胞内交流中起着至关重要的作用。外泌体有很大的潜力成为靶向药物载体、癌症疫苗和非侵入性诊断生物标志物，具有相对高的药物载荷能力、可调节的治疗剂释放、增强的渗透和保留效应、明显的生物降解性和良好的生物相容性和低毒性等广泛优点。随着基础外泌体研究的快速进展，外泌体为基础的治疗方法近年来越来越受到关注。作为标准的中枢神经系统原发性肿瘤，胶质瘤仍面临重大挑战，因为当前的传统治疗方法（手术切除联合放疗和化疗）以及大量新药的努力显示出很少的临床治愈效果。新兴的免疫治疗策略已经在许多肿瘤中展现出令人信服的结果并推动研究人员将其潜力发挥到胶质瘤中。作为胶质瘤微环境的关键组成部分，肿瘤相关巨噬细胞（TAMs）显著地促进了免疫抑制性微环境，并通过各种信号分子强烈地影响胶质瘤的进展，同时提供了新的治疗策略。外泌体将大大助力以TAMs为中心的治疗，作为药物传递载体和液态活检生物标志物。在这里，我们回顾了目前针对胶质瘤TAMs的潜在外泌体介导的免疫治疗，并总结了TAMs促进胶质瘤进展的多样分子信号事件的最新研究。 ©2023. The Author(s).

Exosomes, the cell-derived small extracellular vehicles, play a vital role in intracellular communication by reciprocally transporting DNA, RNA, bioactive protein, chains of glucose, and metabolites. With great potential to be developed as targeted drug carriers, cancer vaccines and noninvasive biomarkers for diagnosis, treatment response evaluation, prognosis prediction, exosomes show extensive advantages of relatively high drug loading capacity, adjustable therapeutic agents release, enhanced permeation and retention effect, striking biodegradability, excellent biocompatibility, low toxicity, etc. With the rapid progression of basic exosome research, exosome-based therapeutics are gaining increasing attention in recent years. Glioma, the standard primary central nervous system (CNS) tumor, is still up against significant challenges as current traditional therapies of surgery resection combined with radiotherapy and chemotherapy and numerous efforts into new drugs showed little clinical curative effect. The emerging immunotherapy strategy presents convincing results in many tumors and is driving researchers to exert its potential in glioma. As the crucial component of the glioma microenvironment, tumor-associated macrophages (TAMs) significantly contribute to the immunosuppressive microenvironment and strongly influence glioma progression via various signaling molecules, simultaneously providing new insight into therapeutic strategies. Exosomes would substantially assist the TAMs-centered treatment as drug delivery vehicles and liquid biopsy biomarkers. Here we review the current potential exosome-mediated immunotherapeutics targeting TAMs in glioma and conclude the recent investigation on the fundamental mechanisms of diversiform molecular signaling events by TAMs that promote glioma progression.© 2023. The Author(s).