Dr. Kiminobu Sugaya

Extracellular vesicles (EVs), particularly exosomes, have emerged as a transformative platform in neurology because of their natural ability to transport proteins, nucleic acids, and signaling molecules between cells. Their capacity to cross biological barriers, including the blood-brain barrier, makes them attractive tools for both diagnostic and therapeutic applications.
In diagnostics, neuron-derived exosomes obtained from blood, saliva, and other biofluids provide a minimally invasive approach to monitor pathological changes occurring within the central nervous system. Exosomal biomarkers, including amyloid-β, phosphorylated tau, neurofilament light chain, microRNAs, and disease-associated nucleic acids, have demonstrated potential for early detection and monitoring of neurodegenerative disorders such as Alzheimer’s disease, Parkinson’s disease, and other neurological conditions.
In therapeutics, exosomes offer several advantages as drug delivery systems (DDS), including low immunogenicity, biocompatibility, and the ability to carry diverse therapeutic cargoes such as small molecules, proteins, siRNA, mRNA, DNA, and gene-editing components. Surface engineering strategies enable targeted delivery to the brain and specific neural cell populations.
Recent advances in engineered exosomes have demonstrated their potential for delivering therapeutic nucleic acids and biologics to the central nervous system. Brain-targeting peptides, surface modification technologies, and scalable manufacturing platforms are accelerating the clinical translation of exosome-based therapeutics.
This presentation will review recent developments in neurological exosome research, including diagnostic biomarkers, therapeutic delivery systems, blood-brain barrier targeting, manufacturing technologies, and future clinical applications. The integration of exosome-based diagnostics and therapeutics may establish a new paradigm for precision neurology and regenerative medicine.