肝纤维化是一种慢性长期疾病，可发展为肝细胞癌（HCC）并最终导致肝功能衰竭。早期诊断和有效治疗仍面临重大挑战。肝脏炎症通过肝星状细胞（HSC）的持续激活和免疫细胞的积累导致肝纤维化。各种免疫细胞之间的细胞内通讯对于介导纤维形成过程中的炎症反应很重要。细胞外囊泡（EV）是细胞自然分泌的脂质双层膜包裹的颗粒，对细胞间通讯和生物活性分子的运输做出了巨大贡献。几乎所有参与肝纤维化的细胞都会释放负载脂质、蛋白质和核酸的 EV。来自肝细胞、免疫细胞和干细胞的 EV 参与介导肝纤维化的炎症微环境。最近，越来越多的基于细胞外囊泡的临床应用出现，为肝纤维化提供了有前景的无细胞诊断和治疗工具，因为它们在发病过程中的免疫调节中发挥着至关重要的作用。基于细胞外囊泡的疗法的优点包括稳定性、生物相容性、低细胞毒性和最小的免疫原性，这凸显了它们在药物递送和肝纤维化特异性治疗方面的巨大潜力。在这篇综述中，我们总结了 EVs 在肝纤维化发病机制中炎症反应中的复杂生物学功能，并评估了 EVs 在肝纤维化诊断和治疗中的潜力。© 2024。作者。

Liver fibrosis, a chronic and long-term disease, can develop into hepatocellular carcinoma (HCC) and ultimately lead to liver failure. Early diagnosis and effective treatment still face significant challenges. Liver inflammation leads to liver fibrosis through continuous activation of hepatic stellate cells (HSCs) and the accumulation of immune cells. Intracellular communication among various immune cells is important for mediating the inflammatory response during fibrogenesis. Extracellular vesicles (EVs), which are lipid bilayer membrane-enclosed particles naturally secreted by cells, make great contributions to cell-cell communication and the transport of bioactive molecules. Nearly all the cells that participate in liver fibrosis release EVs loaded with lipids, proteins, and nucleic acids. EVs from hepatocytes, immune cells and stem cells are involved in mediating the inflammatory microenvironment of liver fibrosis. Recently, an increasing number of extracellular vesicle-based clinical applications have emerged, providing promising cell-free diagnostic and therapeutic tools for liver fibrosis because of their crucial role in immunomodulation during pathogenesis. The advantages of extracellular vesicle-based therapies include stability, biocompatibility, low cytotoxicity, and minimal immunogenicity, which highlight their great potential for drug delivery and specific treatments for liver fibrosis. In this review, we summarize the complex biological functions of EVs in the inflammatory response in the pathogenesis of liver fibrosis and evaluate the potential of EVs in the diagnosis and treatment of liver fibrosis.© 2024. The Author(s).