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M2 macrophage-derived extracellular vesicles + DNase I (M2-EVs@DNase I) is a bioengineered nanotherapeutic designed to treat sepsis and associated multi-organ injury. It consists of the enzyme DNase I encapsulated within extracellular vesicles (EVs) derived from M2-polarized macrophages. The primary mechanism involves the enzymatic degradation of pathogenic circulating cell-free DNA (cfDNA), which is a major driver of systemic inflammation and organ damage in sepsis. By degrading cfDNA, the drug suppresses the activation of the Toll-like receptor 9 (TLR9) signaling pathway. The M2-EV delivery vehicle enhances the stability and half-life of DNase I while providing intrinsic tissue-targeting capabilities and promoting an anti-inflammatory (M2) macrophage phenotype. Preclinical studies in cecal ligation and puncture (CLP) models have demonstrated significant reductions in cfDNA levels, attenuation of lung and kidney injury, and improvement in biochemical markers of organ function.
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