E expression of Toll-like receptor 4 (TLR-4) and subsequently decrease TNF- and IL-1 levels in burninduced inflammation.161 Exosomal miR-155 from bone marrow cells (BMCs) increases the amount of TNF- and subsequently enhances innate immune responses in chronic inflammation.162 Exosomes containing miR-1505p and miR-142-3p derived from dendritic cells (DCs) enhance expression of interleukin ten (IL-10) in addition to a reduce in IL-6 expression.163 Exosomal miR-138 can defend against inflammation by decreasing the expression amount of NF-B, a transcription factor that regulates inflammatory cytokines for example TNF- and IL-18.164 HIF-1inducing exosomal microRNA-23a expression from tubular epithelial cells mediates the cross speak involving tubular epithelial cells and macrophages, advertising macrophage activation and triggering tubulointerstitial inflammation.165 A rat model study demonstrated that bone marrow mesenchymal stem cell (BMSC)-derived exosomes lowered inflammatory responses by modulating microglial polarization and preserving the balance between M2related and M1-related cytokines.165 Melatoninstimulated mesenchymal stem cell (MSC)-derived exosomes increase diabetic wound healing via regulating macrophage M1 and M2 polarization by targeting the PTEN/AKT pathway, and significantly suppressed the proinflammatory things IL-1 and TNF- and lowered the relative gene expression of IL-1, TNF-, and iNOS. c-Kit drug Increasing levels of anti-inflammatory issue IL-10 are connected with rising relative expression of Arg-1.submit your manuscript www.dovepress.comInternational Journal of Nanomedicine 2021:DovePressDovepressGurunathan et alImmunomodulators are important things for the prevention and remedy of problems occurring on account of an over PKCĪ· site high-spirited immune response, like the SARS-CoV -2-triggered cytokine storm top to lung pathology and mortality seen throughout the ongoing viral pandemic.167 MSC-secreted extracellular vesicles exhibit immunosuppressive capacity, which facilitates the regulation of the migration, proliferation, activation, and polarization of a variety of immune cells, advertising a tolerogenic immune response while inhibiting inflammatory responses.168 Collagen scaffold umbilical cord-derived mesenchymal stem cell (UC-MSC)-derived exosomes induce collagen remodeling, endometrium regeneration, rising the expression with the estrogen receptor /progesterone receptor, and restoring fertility. In addition, exosomes modulate CD163+ M2 macrophage polarization, reduce inflammation, raise anti-inflammatory responses, facilitate endometrium regeneration, and restore fertility via the immunomodulatory functions of miRNAs.169 Exosomes released into the airways throughout influenza virus infection trigger pulmonary inflammation and carry viral antigens and it facilitate the induction of a cellular immune response.170 Shenoy et al171 reported that exosomes derived from chronic inflammatory microenvironments contribute towards the immune suppression of T cells. These exosomes arrest the activation of T cells stimulated by way of the T cell checkpoint (TCR). Exosomes secreted by typical retinal pigment epithelial cells (RPE) by rotenonestimulated ARPE-19 cells induce apoptosis, oxidative injury, and inflammation in ARPE-19 cells. Exosomes secreted beneath oxidative strain induce retinal function damage in rats and upregulate expression of Apaf1. Overexpression of Apaf1 in exosomes secreted below oxidative anxiety (OS) may cause the inhibition of cell proliferat.