AIM: To investigate the effects of human induced pluripotent stem cell-derived exosomes( hi PSC-exo) on cell viability,capillarylike structure formation,and senescence in endothelial cells exposed to high glucose. METHODS: Exosomes were isolated from the conditional medium of hi PSCs and confirmed by transmission electron microscopy,nanoparticle tracking analysis,and Western blot analysis using Alix and CD63 as markers. hi PSC-exo were labeled with PKH26 for tracking. Cultured HUVECs were treated with high glucose(33 mmol / L) with or without hi PSC-exo(20 mg / L) for 48 h,and cell viability,capillary tube formation,and senescence were assessed. RESULTS: hi PSC-exo showed a typical cup shape and could be taken up by human umbilical vascular endothelial cells(HUVECs) in a concentration-dependent manner. When exposed to high glucose,viability and tube formation in HUVECs was significantly reduced,whereas the proportion of senescent cells was higher compared to that in control HUVECs( P < 0. 01). Furthermore,hi PSC-exo restored cell viability and capillary-like structure formation,and reduced senescence in HUVECs exposed to high glucose(P < 0. 01). However,hi PSC-exo had minimal effects on normal HUVECs. Therefore,stem cell-derived exosomes can promote cell proliferation, enhance capillary-like structure formation, and reduce senescence in endothelial cells exposed to high glucose.CONCLUSION: Our study highlights the role of exosomes derived from hi PSC and may provide a new strategy for maintaining vascular health,preventing vascular aging,and avoiding pathological vascular remodeling that occurs in many diseases. METHODS: Exosomes were isolated from the conditional medium of hi PSCs and confirmed by transmission electron microscopy, nanoparticle tracking analysis, and Western blot analysis using Alix and CD63 as markers. Hi PSC-exo were labeled with PKH26 for tracking. Cultured HUVECs were treated with high glucose (33 mmol / L) with or without RESULTS: hi PSC-exo showed a typical cup shape and could be be taken up by human umbilical vascular endothelial cells HUVECs) in a concentration-dependent manner. When exposed to high glucose, viability and tube formation in HUVECs was significantly reduced, while the proportion of senescent cells was higher compared to that in control HUVECs (P < 0. 01). However, hi PSC-exo restored cell viability and capillary-like structure formation, and reduced senescence in HUVECs exposed to high glucose (P <0.01) Thus, stem cell-derived exosomes can promote cell proliferation, enhance capillary-like structure formation, and reduce senescence in endothelial cells exposed to high glucose. CONCLUSION: Our study highlights the role of exosomes derived from hi PSC and may provide a new strategy for maintaining vascular health, preventing vascular aging, and avoiding pathological vascular remodeling that occurs in many diseases.