Therapeutic and Pathogenic Dimensions of Extracellular Vesicles: A Decade of Comparative Bibliometric Mapping (2014–2024)

Abstract

Background: Extracellular vesicles (EVs) embody a central paradox in contemporary biomedicine—acting simultaneously as mediators of disease and as vehicles for therapeutic innovation. Despite the exponential growth of literature exploring these dual roles, a comprehensive quantitative comparison of EV research in therapy and pathogenesis has remained unexplored. Objective: This study addresses this gap through a systematic bibliometric analysis of global EV research (2014–2024), providing a visual overview of the current research landscape, emerging trends, and the convergence potential between therapeutic and pathogenic domains. Methods: Conducted in accordance with the PRISMA framework, this bibliometric investigation utilized the Scopus database. A structured search identified 58,314 publications, with 15,153 (therapy) and 7,776 (pathogenesis) meeting the inclusion criteria. VOSviewer (version 2010) was employed for network construction and visualization of keyword co-occurrence, citation networks, and thematic clusters. Results: The analysis uncovered a definitive paradigm shift, with therapeutic output overtaking pathogenesis in 2019 and maintaining a steeper growth trajectory. However, this quantitative transition conceals a deep-seated structural divide. The two domains have evolved as distinct intellectual silos, with specialized high-impact clusters pathogenesis in neurodegenerative biomarkers (FWCI=2.80) and therapy in delivery platforms like mRNA vaccines (FWCI=2.63). Crucially, this segregation is reified by geographically distinct collaborative networks and a parallel, non-interacting investigation of shared biological mechanisms (e.g., neural communication). Conclusion: This study provides the first quantitative map of the EV field's dualism, revealing that its central challenge is not a lack of activity, but a lack of integration. The findings underscore an urgent need to forge strategic links between pathogenic insight and therapeutic engineering to unlock the full clinical potential of EVs.