Elham Alsahafi

Plant cells release tiny membranous vesicles called extracellular vesicles (EVs), which are rich in lipids, proteins, nucleic acids, and pharmacologically active compounds. These plant-derived EVs (PDEVs) are safe and easily extractable and have been shown to have therapeutic effects against inflammation, cancer, bacteria, and aging. They have shown promise in preventing or treating colitis, cancer, alcoholic liver disease, and even COVID-19. PDEVs can also be used as natural carriers for small-molecule drugs and nucleic acids through various administration routes such as oral, transdermal, or injection. The unique advantages of PDEVs make them highly competitive in clinical applications and preventive healthcare products in the future. This review covers the latest methods for isolating and characterizing PDEVs, their applications in disease prevention and treatment, and their potential as a new drug carrier, with special attention to their commercial viability and toxicological profile, as the future of nanomedicine therapeutics. This review champions the formation of a new task force specializing in PDEVs to address a global need for rigor and standardization in PDEV research.

Background The spleen is a multi‐functional organ that supports the immune system and is involved in the production of platelets and red blood cells. People with splenic dysfunctions or asplenia are predisposed to infection; hence, adults with splenic dysfunction, splenectomy or congenital asplenia may require antibiotic prophylaxis prior to dental procedures to prevent possible bacteraemia which could be caused by dental extraction. Aims To assess the current evidence to determine whether adults with splenic dysfunction, splenectomy or congenital asplenia require antibiotic prophylaxis prior to dental extraction. Materials and Methods A systematic review following the Preferred Reporting Item for Systematic Review and Meta‐analyses (PRISMA) guidelines (registration number: CRD42021230933) was conducted using Ovid MEDLINE and EMBASE databases. PROSPERO was searched for ongoing or recently completed systematic reviews and The ClinicalTrials.gov was searched for ongoing or recently completed trials. The evidence of all articles was evaluated based on the Oxford Level of Evidence. The Grading of Recommendations Assessment, Development and Evaluation approach was used to summarise the evidence. Results Nine articles published from 1984 to 2016 were included in the data synthesis and analysis. The included articles presented level 5 evidence; hence, all were identified at level D of the recommendation. Conclusions Antibiotic prophylaxis should not be routinely prescribed for adults with splenic dysfunctions, splenectomy or congenital asplenia prior to dental extraction as sepsis post‐dental extraction in this group of patients is very rare.