Recent advances in membrane vesicles of Streptococcus mutans : biogenesis, regulations, and functions

Background Streptococcus mutans (S. mutans) is a major cariogenic pathogen in the oral cavity that actively releases membrane vesicles (MVs) encapsulating proteins, lipids, and nucleic acids. These highly heterogeneous MVs not only help regulate homeostasis of the local oral microecology but may also affect systemic health. A comprehensive review of the physiological characteristics of S. mutans MVs is therefore of considerable research value.Objective By summarizing the latest advances in research on S. mutans MVs, this review provides a broad overview of the relevant studies to elucidate their physiological and pathological characteristics.Design We conducted an extensive literature search in PubMed, Web of Science, and Google Scholar. The search strategy combined terms related to MVs and S. mutans, including ‘membrane vesicles,’ ‘extracellular vesicles,’ ‘bacterial extracellular vesicles,’ ‘microbial extracellular vesicles,’ ‘MVs,’ ‘EVs,’ ‘bEVs,’ ‘MEVs,’ ‘Streptococcus mutans,’ ‘S. mutans,’ ‘Gram-positive,’ ‘biogenesis,’ ‘cargo,’ and ‘biological functions.’ Literature published from database inception to August 2026 was included. This review delineates the biogenesis, cargo composition, and functions of MVs, and highlights current research challenges and future directions.Results S. mutans MV biogenesis is driven jointly by environmental signals and bacterial gene regulatory networks. As efficient delivery vehicles for toxins and various bioactive factors, MVs constitute a core molecular tool through which S. mutans adapts to the complex oral microenvironment, competes with other species, and initiates pathogenic processes. MVs not only regulate the balance of the local oral microecology but also serve as key mediators of intermicrobial signaling and microbe–host cross-kingdom interactions. Deciphering the pathophysiological mechanisms of S. mutans MVs may revolutionize caries prevention and control strategies, providing a theoretical basis for developing novel anticaries vaccines and oral targeted therapies, while also offering new research entry points for elucidating the intrinsic links between oral infections and systemic diseases.Conclusions S. mutans MV biogenesis is driven jointly by environmental signals and bacterial gene regulatory networks. As efficient delivery vehicles for toxins and various bioactive factors, MVs constitute a core molecular tool through which S. mutans adapts to the complex oral microenvironment, competes with other species, and initiates pathogenic processes. MVs not only regulate the balance of the local oral microecology but also serve as key mediators of intermicrobial signaling and microbe–host cross-kingdom interactions. Deciphering the pathophysiological mechanisms of S. mutans MVs may revolutionize caries prevention and control strategies, providing a theoretical basis for developing novel anticaries vaccines and oral targeted therapies, while also offering new research entry points for elucidating the intrinsic links between oral infections and systemic diseases.