ESR1 and osteoporosis: For instance, Rhizoma Drynariae-derived nanovesicles (RDNVs) enhance osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs) via estrogen receptor α (ERα) targeting [35]; Pueraria lobata-derived EVs reverse osteoporosis by modulating hBMSC mineralization [36]; and Zingiber officinale-derived EVs (Gr-EVs) synergistically reduce bone resorption by inhibiting P. gingivalis virulence [37].