Gene‐Engineered Cerium‐Exosomes Mediate Atherosclerosis Therapy Through Remodeling of the Inflammatory Microenvironment and DNA Damage Repair

Abstract The pro‐inflammatory immune microenvironment in the localized lesion areas and the absence of DNA damage repair mechanisms in endothelial cells serve as essential accelerating factors in the development of atherosclerosis. The lack of targeted therapeutic strategies represents a significant limitation in the efficacy of therapeutic agents for atherosclerosis. In this study, Genetically engineered SNHG12‐loaded cerium‐macrophage exosomes (Ce‐Exo) are designed as atherosclerosis‐targeting agents. In vivo studies demonstrated that Ce‐Exo exhibited multivalent targeting properties for macrophages, with a 4.1‐fold higher atherosclerotic plaque‐aggregation ability than that of the control drugs. This suggests that Ce‐Exo has a higher homing capacity and deeper penetration into the atherosclerotic plaque. In apolipoprotein E‐deficient mice, Ce‐Exo found to effectively remodel the immune microenvironment in the lesion area, repair endothelial cell damage, and inhibit the development of atherosclerosis. This study provides a novel approach to the treatment of atherosclerosis and demonstrates the potential of cell‐derived drug carriers in biomedicine.