Mesenchymal Stem Cells and Their Extracellular Vesicles: Therapeutic Mechanisms for Blood–Spinal Cord Barrier Repair Following Spinal Cord Injury

Int. J. Mol. Sci., 2024 · DOI: 10.3390/ijms252413460 · Published: December 16, 2024

Spinal Cord Injury Regenerative Medicine Genetics

Simple Explanation

Spinal cord injuries disrupt the blood-spinal cord barrier (BSCB), which normally protects the spinal cord. This disruption allows harmful substances and immune cells to enter, worsening the damage. Mesenchymal stem cells (MSCs) and their extracellular vesicles (MSC-EVs) can help repair the BSCB. MSCs improve the barrier by enhancing the connection between cells and reducing inflammation. MSC-EVs, which are like tiny packages released by MSCs, carry beneficial molecules that replicate the therapeutic effects of MSCs. They offer a cell-free alternative for treatment.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
MSCs and MSC-EVs reduce BSCB permeability after SCI, promoting vascular stability and functional recovery in preclinical models.
2
MSCs enhance endothelial cell coverage by pericytes through secretion of bioactive molecules, improving vascular stability and preventing barrier leakage.
3
Both MSCs and MSC-EVs upregulate tight junction proteins (occludin, claudin-5, ZO-1), restoring BSCB integrity and reducing neuroinflammation and tissue damage.

Research Summary

Spinal cord injury (SCI) disrupts the blood–spinal cord barrier (BSCB) exacerbating damage by allowing harmful substances and immune cells to infiltrate spinal neural tissues from the vasculature. Mesenchymal stromal/stem cells (MSCs) and their secreted extracellular vesicles (MSC-EVs) have gained attention for their regenerative, immunomodulatory, and anti-inflammatory properties in promoting BSCB repair. Despite these challenges, both therapeutic approaches represent significant potential for treating SCI by targeting BSCB repair and improving patient outcomes.

Practical Implications

Therapeutic Potential for SCI

MSCs and MSC-EVs offer promising avenues for treating SCI by targeting BSCB repair and improving patient outcomes.

Cell-Free Therapy Alternative

MSC-EVs provide a cell-free alternative to traditional MSC-based therapies, potentially enhancing treatment accessibility and safety.

Vascular Stability and Repair

MSCs and MSC-EVs promote vascular stability and repair by enhancing endothelial cell-pericyte interactions and restoring tight junction integrity.

Study Limitations

1
Further optimization of MSC-EV production, dosing, and delivery protocols is needed.
2
Larger clinical trials are necessary to fully establish the safety and efficacy of MSC and MSC-EV therapies.
3
Standardized dosing regimens for MSC-EVs in different patient populations are currently lacking.

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