Mesenchymal stem cell-derived exosomes: therapeutic opportunities and challenges for spinal cord injury

Stem Cell Research & Therapy, 2021 · DOI: https://doi.org/10.1186/s13287-021-02153-8 · Published: January 7, 2021

Spinal Cord Injury Regenerative Medicine Genetics

Simple Explanation

Spinal cord injury (SCI) often leads to serious motor and sensory dysfunction of the limbs below the injured segment. As there is no effective treatment method, the prevention, treatment, and rehabilitation of patients with SCI have become urgent problems to be solved. Mesenchymal stem cells (MSCs) have attracted more attention in the treatment of SCI. Although MSC therapy can reduce injured volume and promote axonal regeneration, its application is limited by tumorigenicity, a low survival rate, and immune rejection. Accumulating literature shows that exosomes have great potential in the treatment of SCI. In this review, we summarize the existing MSC-derived exosome studies on SCI and discuss the advantages and challenges of treating SCI based on exosomes derived from MSCs.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Exosomes derived from MSCs have anti-inflammatory effects, reducing pro-inflammatory cytokines and promoting an anti-inflammatory environment conducive to functional recovery after SCI.
2
MSC-exosomes can promote macrophage polarization, specifically triggering the shift from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, thereby aiding tissue remodeling and axonal regeneration.
3
BMSC-derived exosomes can effectively reduce SCI-induced A1 astrocytes by inhibiting nuclear translocation of NF-κB p65.

Research Summary

This review discusses the potential of mesenchymal stem cell (MSC)-derived exosomes as a therapeutic strategy for spinal cord injury (SCI), highlighting their advantages over traditional MSC therapy. MSC-derived exosomes offer several benefits, including easier procurement and storage, reduced ethical concerns, the ability to penetrate the blood-spinal cord barrier (BSCB), and a lack of tumorigenicity. The review also addresses the challenges associated with MSC-exosome therapy, such as the need for standardized separation methods, optimized storage and transportation, and a clearer understanding of the therapeutic mechanisms and target components within exosomes.

Practical Implications

Therapeutic Potential

MSC-derived exosomes present a promising cell-free therapeutic approach for SCI due to their ability to promote functional recovery and potentially serve as biomarkers.

Drug Delivery System

Exosomes can be used as a drug-delivery system to treat SCI.

Clinical Translation

Further research is needed to optimize MSC-derived exosomes and clarify their specific role in SCI to facilitate clinical translation and improve treatment outcomes.

Study Limitations

1
Lack of standardized separation methods for exosomes.
2
Need for optimized storage, preservation, and transportation methods.
3
Limited research on the specific therapeutic mechanisms and target components within exosomes beyond miRNAs.

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