Asian Journal
Of Traditional Medicines

Exosomes are nanosized extracellular vesicles (30–150 nm) secreted by almost all cells, mediating intercellular communication by  delivering bioactive molecules such as proteins, nucleic acids, and lipids. In diabetic complications, they act as a “double-edged  sword”: pathologically, they propagate damaging signals that exacerbate disease progression, whereas therapeutic exosomes from specific sources exert multi-targeted therapeutic effects. Traditional Chinese Medicine (TCM), characterized by unique  holistic regulation, can modulate the secretion and cargo composition of exosomes in vivo, thereby offering a novel synergistic  strategy for the treatment of diabetic complications. This paper reviews the latest research progress on exosomes and exosome-TCM combination strategies in five diabetic complications, including diabetic nephropathy, diabetic encephalopathy, diabetes  complicated with cerebral infarction, diabetic wound healing, and diabetic retinopathy. This review analyzes their cell source  specificity and TCM-regulated mechanisms. It also discusses the potential of exosomes as early diagnostic biomarkers and as  engineered TCM-related delivery platforms. Current exosome research still faces challenges, such as heterogeneity control,  large-scale preparation, and clinical supervision. However, emerging technologies including genetic modification and artificial intelligence combined with personalized TCM regulation strategies are accelerating their clinical translation, providing a  systemic reference for the integrated research and clinical development of exosome-TCM in the field of diabetic complications.

exosomes, diabetic complications, Traditional Chinese Medicine, therapeutic mechanisms, drug delivery systems