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Figure 2. Bidirectional effects of EVs from different cellular sources in the central nervous system. (A) MSC-EVs inhibit neuronal death, modulate neuroinflammation, and regulate autophagy; (B) Neuronal EVs promote the clearance of Aβ, but may also inhibit neuronal viability. Astrocyte-derived EVs induce apoptosis in surrounding neurons. EVs derived from microglia exhibit a dual role, exacerbating neuronal injury while also reducing neuronal apoptosis; (C) EVs from macrophages promote the onset of neuroinflammation. Meanwhile, EVs from naïve macrophages are capable of delivering neurotrophic factors to the brain, exerting neuroprotective effects. MSC: Mesenchymal stem cell; EV: extracellular vesicle; TNF-α: tumor necrosis factor alpha; IL-6: Interleukin-6; Aβ: amyloid-beta; BDNF: brain-derived neurotrophic factor; CNS: central nervous system. Created in BioRender. yinghan, h. (2025) https://BioRender.com/c2ebp43