Introduction: According to a report by the World Health Organization in 2020, stroke is the second leading cause of death worldwide. The lethal and debilitating nature of stroke greatly increases the burden on ociety and families. The main treatments for stroke are intravenous thrombolysis and mechanical thrombectomy. Both treatment strategies have limited time frames, and their effectiveness is still suboptimal. To achieve better results, research on new therapeutic targets is essential. Microglia are the main members of the regulatory cells of the central nervous system, which play an important role in the pathogenesis and progression of stroke. M1 microglia cause neuroinflammation and induce neurotoxic effects, while M2 microglia inhibit neuroinflammation and promote neurogenesis, thus exerting a series of neuroprotective effects. Most of the cells in the human body are able to secrete exosomes. Exosomes have become an important means of signaling betweencells. Recent studies have shown that different miRNAs transferred by exosomes help to polarize microglia into different phenotypes. Search Method: After conducting an initial search in the databases, 10 articles were found. From those, 5 articles were chosen as the source documents for this review. Result: Stroke remains a serious, fatal, and debilitating neurological disease to this day. Therefore, research on new treatment methods andgoals is of particular importance. Recent studies have shown that microglia polarization is strongly associated with stroke progression, and M1 microglia exacerbate stroke-induced brain damage by promoting neuroinflammation. On the other hand, M2 microglia have a significant neuroprotective effect and promote neuronal recovery. Conclusion: Various studies have shown that exosomes from different sources regulate microglia polarization. This suggests that targeting the secretion of specific exosomes may enable us to regulate microglia polarization. In addition, the ability of exosomes to cross the blood-brain barrier makes them potentially an ideal vehicle for drug delivery to the central nervous system. In animal models of stroke, using endogenous exosomes or exosomes as carriers to transfer certain drug molecules and promote M2 microglia polarization has demonstrated effective therapeutic results and polarized microglia can also promote the secretion of unique exosomes which have a neuroprotective role. Therefore, targeting exosomes that regulate microglia and exosomes secreted by polarized microglia may be a new approach to treating stroke and improving its prognosis.

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