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Lactobacillus -derived exosomes have been used as nanocarriers for targeted delivery of TNF- siRNA to intestinal inflammatory cells, effectively silencing this key pro-inflammatory cytokine ( Escherichia coli Nissle 1917 (EcN) were co-loaded with manganese dioxide (MnO 2 ) nanozymes and the phosphodiesterase-4 inhibitor roflumilast (Song et al., 2024

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A robust immune system is essential for skin health because it protects against infections, inflammation, and environmental stresses that can alter skin appearance

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2 , and is generally not recommended in advanced OA with diffuse degeneration (Minas et al., 2010