Extracellular vesicle omics assisted disease management

Nanoscale vesicles released by cells mirror tissue and immune states across biofluids, offering a minimally invasive window into human disease. This review uses extracellular vesicle (EV) omics as a unifying thread and highlights the advantages of EVs across diagnosis, therapy, and prevention. On the diagnostic front, proteomics and metabolomics are proximal to pathology and responsive to temporal changes, enabling extraction of high-dimensional features from minimally invasive specimens that improve early screening, stratification, and pan-cancer detection. Therapeutically, drawing on stem cell and immune cell EV exemplars, integrated proteomics, metabolomics, and glycomics pinpoint effective cargo and key pathways and distill these into traceable critical quality attributes (CQAs) that inform source selection, process optimization, and patient stratification; in parallel, biomimetic EVs use omics data to guide their assembly and targeting, helping improve yield and consistency. Nature-derived vesicles, such as plant EVs and microbial outer membrane vesicles (OMVs), contribute to both preventive and therapeutic interventions, guided by omics profiling of their cargo and host responses. Finally, we outline a practical roadmap that harmonizes pre-analytics and orthogonal characterization, integrates multi-omics around a proteome and metabolome backbone, pairs external validation with decision analysis to establish clinical utility, and defines a minimal omics fingerprint, thereby moving EVs from concept to interpretable, reproducible, and deployable applications.