**Abstract**

This is an extraordinary time in cell biology with evolving data pushing a reconsideration of the stability of cell systems and the regulatory mechanisms underlying cell phenotypes, especially the functional cell phenotypes. In this chapter, we will explore new insights into stem cell and extracellular vesicle biology with a focus on the role of extracellular vesicles in normal stem cell physiology as well as in various disease states. Extracellular vesicles (EVs) are being recognized as influential mediators of cellular function and potential experimental therapeutic strategies for a number of disorders outlined in this review. An evolving paradigm indicates a dynamic flux of EV populations within these disease states. We conclude our discussion of EV by extending our knowledge of robust EV biology toward disease detection and prognostication. Characterizing the biophysical and functional changes of vesicles amid disease progression or regression enables investigators to merge this information flux with existing deep learning computational and statistical techniques—allowing knowledge to be abstracted from large data sets profiling the biology of EVs within various disease states. Understanding how EV population shifts represent disease regression or progression creates paramount potential for EVs as salient and clinically relevant diagnostic and prognosticating tools.

**Keywords:** stem cell continuum, extracellular vesicles, deep learning, biomarkers
