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Akkermansia muciniphila-derived extracellular vesicles (AmEVs) are nano-sized vesicles (approximately 90-95 nm) secreted by the beneficial gut bacterium *Akkermansia muciniphila*. These vesicles contain bioactive macromolecules, including proteins and lipids, that mediate the bacterium's therapeutic effects without the need for live bacterial colonization. AmEVs function by enhancing intestinal barrier integrity through the regulation of tight junction proteins, modulating inflammatory responses via Toll-like receptor (TLR2/4) signaling pathways, and influencing the gut-brain axis. Preclinical studies have demonstrated their potential in treating metabolic disorders (obesity, type 2 diabetes), inflammatory bowel disease, and neurological conditions such as ischemic stroke and cognitive dysfunction. In stroke models, intravenous administration has been shown to cross the blood-brain barrier, reduce neuroinflammation, and promote myelin repair by activating astrocyte-derived pleiotrophin (PTN)–PTPRZ1 signaling.
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