Long I, Abdo Qaid EY. Exosomes as emerging mediators and therapeutic vehicles in painful diabetic neuropathy: From pathophysiology to clinical translation. World J Diabetes 2026; 17(10): 123286 [DOI: 10.4239/wjd.123286]
Corresponding Author of This Article
Idris Long, Associate Professor, School of Health Sciences, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia. idriskk@usm.my
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Endocrinology & Metabolism
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review-article
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Long I, Abdo Qaid EY. Exosomes as emerging mediators and therapeutic vehicles in painful diabetic neuropathy: From pathophysiology to clinical translation. World J Diabetes 2026; 17(10): 123286 [DOI: 10.4239/wjd.123286]
World J Diabetes. Oct 15, 2026; 17(10): 123286 Published online Oct 15, 2026. doi: 10.4239/wjd.123286
Exosomes as emerging mediators and therapeutic vehicles in painful diabetic neuropathy: From pathophysiology to clinical translation
Idris Long, Entesar Yaseen Abdo Qaid
Idris Long, School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu 16150, Kelantan, Malaysia
Entesar Yaseen Abdo Qaid, Unit of Physiology, Faculty of Medicine, AIMST University, Semeling 08100, Kedah, Malaysia
Co-corresponding authors: Idris Long and Entesar Yaseen Abdo Qaid.
Author contributions: Long I and Abdo Qaid EY planned the conceptual framework, wrote, and reviewed article, contributed equally to this study as co-corresponding authors; all authors contributed to conception, literature search, drafting, critical revision, and final approval.
AI contribution statement: During the preparation of this manuscript, the authors used ChatGPT (OpenAI) to assist with language editing, improving clarity, refining sentence structure, and drafting responses to reviewers. All scientific content, interpretation of the literature, data verification, critical revision, and final approval of the manuscript were performed solely by the authors. The authors accept full responsibility for the accuracy, originality, and integrity of the manuscript.
Supported by Fundamental Research Grant Scheme of the Ministry of Higher Education, Malaysia, No. FRGS/1/2024/SKK10/USM/02/8.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Idris Long, Associate Professor, School of Health Sciences, Universiti Sains Malaysia, Health Campus, Jalan Raja Perempuan Zainab, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia. idriskk@usm.my
Received: May 20, 2026 Revised: July 11, 2026 Accepted: September 4, 2026 Published online: October 15, 2026 Processing time: 142 Days and 11.8 Hours
Core Tip
Core Tip: Exosomes play a central role in painful diabetic neuropathy (PDN) by mediating pathological intercellular signaling while also serving as promising therapeutic vehicles targeting neuroinflammation, axonal degeneration, and pain sensitization. Circulating exosomal microRNA and protein signatures are promising candidate biomarkers, but their clinical application is currently limited by the lack of standardized reference ranges, unresolved specificity across diabetic complications, and confounding effects of diabetic nephropathy, requiring validation in large prospective studies. Likewise, mesenchymal stem cell-derived and engineered exosomes demonstrate robust therapeutic efficacy and neuroprotective effects in preclinical PDN models; however, no clinical trials have yet evaluated these approaches in PDN patients, underscoring the need for clinical translation before they can be considered disease-modifying therapies.
