The role of extracellular vesicles in the treatment of tendinopathy by regulating the pathological immune microenvironment

Tendinopathy, a common degenerative condition among athletes and middle-aged individuals, leads to pain and functional limitations. Traditional treatments focus on symptom relief but do not address the underlying tendon pathology. New evidence points to immune microenvironment dysregulation as a key factor in tendinopathy development, often due to mechanical overload. Extracellular vesicles (EVs), nanosized particles containing active molecules, show promise in enhancing tendon healing by modulating the pathological microenvironment. This review explores the molecular mechanisms of the immune microenvironment in tendinopathy, highlights recent research on EVs in tendinopathy treatment, and discusses future research directions.