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Extracellular vesicles (EVs) are cell-secreted nanovesicles that play an important role in long-range cell-cell communication. Although EVs pose a promising alternative to cell-based therapy, targeted in vivo delivery still falls short. Many studies have explored the surface modification of EVs to enhance their targeting capabilities. However, to our knowledge, there are no standardized practices to confirm the successful surface modification of EVs or calculate the degree of conjugation on EV surfaces (conjugation efficiency). These pieces of information are essential in the reproducibility of targeted EV therapeutics and the determination of optimized conjugation conditions for EVs to see significant therapeutic effects in vitro and in vivo. This review will discuss the vast array of techniques adopted, technologies developed, and efficiency definitions made by studies that have calculated EV/nanoparticle surface conjugation efficiency and how differences between studies may contribute to differently reported conjugation efficiencies.

Extracellular vesicles (EVs) are cell-secreted nanoscale vesicles with important roles in cell-cell communication and drug delivery. Although EVs pose a promising alternative to cell-based therapy, targeted delivery in vivo is lacking. Their surface is often modified to endow them with active targeting molecules to enable specific cell uptake and tailor EV biodistribution. A dominant paradigm has been to evaluate the EV surface functionalization using bulk analysis assays, such as western blotting and bead-based flow cytometry. Yet, the heterogeneity of EVs is now recognized as a major bottleneck for their clinical translation. Here, we engineer the EV surface at the single-vesicle level. We applied orthogonal platforms with single vesicle resolution to determine and optimize the efficiency of conjugating the myelin-targeting aptamer LJM-3064 to single EVs (Apt-EVs). The aptamers were conjugated using either lipid insertion or covalent protein modification, followed by an assessment of single-EV integrity and stability. We observed unique aptamer conjugation to single EVs that depends on EV size. Our study underscores the importance of single vesicle analysis for engineering EVs and provides a novel single-EV-based framework for modifying EV surfaces.