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As indication bias is frequent in retrospective studies (the choice of treatment is generally influenced by patients characteristics), we used a propensity score to balance for these differences and recreate, as much as possible, the gold standard of a randomized trial

All the patients gave consent to be included in the study

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Other researchers have directly loaded therapeutic molecules into exosomes using drugs or gene tools, creating customized exosomes with enhanced neuroprotective, anti-inflammatory, or angiogenic properties, including GPX4 activators, clustered regularly interspaced short palindromic repeats (CRISPR)/Caspase-9, and specific miRNA overexpression methods (53, 55, 57, 58)

In addition, probiotics synthesize antimicrobial peptides, notably bacteriocins, which target pathogenic bacteria by disrupting cell membrane integrity, inhibiting cell wall synthesis, or interfering with essential metabolic pathways (29)