Therapeutic applications of mesenchymal stem cell-derived extracellular vesicles in pain management: A narrative review of emerging evidence and future directions

Figure 3 Extracellular vesicle-mediated activation of phosphoinositide 3-kinase/protein kinase B signaling pathway promotes neuronal survival and neuroprotection. Ligand binding to surface receptors activates phosphoinositide 3-kinase, leading to protein kinase B phosphorylation, upregulation of antiapoptotic proteins, and downregulation of proapoptotic factors. Extracellular vesicle cargo enhances protein kinase B phosphorylation, supporting neuronal survival, synaptic maintenance, and resistance to neurodegenerative stress. EVs: Extracellular vesicles; PI3K: Phosphoinositide 3-kinase; AKT: Protein kinase B.