Level D· Scientific groundwork from lab and animal studiesNarrative ReviewEurope PMCOpen access

Roles of exosomes in microenvironment-related premature ovarian insufficiency: mechanisms and therapeutic intervention

Yang Y., Rui B., Kim JH.

Narrative Review, published in Reprod Biol Endocrinol (2025) — summary generated from the PubMed abstract.

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Level D· Scientific groundwork from lab and animal studiesEvidence level of this study

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

  • Level A · Stronger Clinical Evidence
  • Level B · Emerging clinical evidence with positive signals
  • Level C · Early human research exploring benefits
  • Level D · Scientific groundwork from lab and animal studies
  • Emerging · Emerging topic under active research
Read the A–D evidence level guide

This page is generated from the PubMed record. The Thai description is an automated summary of bibliographic fields and the abstract, not a full translation, and is not medical advice.

Study type
Narrative Review
Journal
Reprod Biol Endocrinol (2025)
Reported sample size
—
Source database
Europe PMC
PMID
41449456
PMCID
PMC12849468
DOI
10.1186/s12958-025-01514-9

Abstract (original English)

Exosomes are nanoscale vesicles that traffic bioactive cargo and modulate cell-cell communication within the ovarian niche. They are pivotal mediators in ovarian microenvironment-related premature ovarian insufficiency (omePOI): pathogenic exosomes propagate injury, whereas therapeutic Exosomes restore homeostasis to shape the niche and influence disease onset and course. However, omePOI still lacks sensitive predictive biomarkers and disease-modifying therapies; moreover, the complexity of the ovarian niche-encompassing extracellular matrix, stromal and immune compartments, vasculature, and metabolic-redox balance-poses substantial translational challenges. In this Review, we first summarize the current clinical challenges in diagnosing and managing omePOI. We then focus on reported correlations between exosomal alterations and omePOI, and postulate mechanisms by which these vesicles influence disease biology across apoptosis/mitochondrial injury, senescence, inflammation and innate-adaptive crosstalk, angiogenesis, fibrosis/extracellular matrix, and metabolic-redox pathways. Finally, we highlight the potential value of exosomal changes as biomarkers for predicting omePOI and discuss exosomal interventions, including mesenchymal stromal cell-derived and engineered Exosomes, as well as exosome-biomaterial composites together with design principles from ovarian tissue engineerin

What this study does not prove

  • • This study does not prove SVF is an approved treatment or a replacement for standard care.
  • • This is a narrative review: it collects no new patient data and does not systematically appraise evidence quality.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

How we grade evidence
OvaryExtracellular MatrixAnimalsHumansFemaleExosomesPrimary Ovarian InsufficiencyCellular MicroenvironmentBiomarkers

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