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EVs-SIRT1-VEGF is an engineered biologic therapeutic consisting of extracellular vesicles (EVs) derived from bone marrow mesenchymal stem cells (BMSCs). These EVs are modified with two functional modules: a SIRT1 protein module for therapeutic effect and a VEGF-targeting aptamer module for precision delivery. The SIRT1 protein is enriched in the EVs by overexpressing it in the source BMSCs using a recombinant adenovirus. The targeting module utilizes cholesterol-modified aptamers that bind to vascular endothelial growth factor (VEGF) on the surface of vascular endothelial cells (VECs). Once targeted to VECs, the EVs are internalized, releasing SIRT1 to activate the Nrf2 pathway and regulate oxidative stress, thereby reversing endothelial-mesenchymal transition (EndMT) and reducing inflammation in atherosclerotic plaques.
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