Advanced microfluidic systems with integrated microstructures for enhanced exosome isolation and analysis

Exosomes, as extracellular vesicles involved in intercellular communication, are emerging as important biomarkers for liquid biopsy and disease monitoring. Conventional methods for isolating exosomes, such as ultracentrifugation and polymer precipitation, have shown limitations of low efficiency, lengthy processing, and poor scalability. To address these challenges, microfluidics integrated with microstructures has gained prominence as a high-throughput, automated alternative. This review discusses recent advances in these integrated platforms, focusing on the synergistic mechanisms of physical confinement and chemical affinity for enhanced exosome capture. We systematically categorize isolation strategies into immunoaffinity-based, size-based approaches, and hybrid strategies, evaluating their performance in complex biological matrices. Additionally, we explore the integration of these systems with advanced biosensing or analytical technologies, highlighting their transformative potential for precise, scalable and clinically viable exosome-based diagnostics and therapeutics.