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  4. The Role of Exosomes from Mesenchymal Stem Cells in Spinal Cord Injury: A Systematic Review

The Role of Exosomes from Mesenchymal Stem Cells in Spinal Cord Injury: A Systematic Review

International Journal of Stem Cells, 2024 · DOI: https://doi.org/10.15283/ijsc23092 · Published: November 29, 2023

Spinal Cord InjuryRegenerative MedicineGenetics

Simple Explanation

Spinal cord injury (SCI) leads to impairment of motor, sensory, and autonomic nervous functions, placing a heavy burden on families and healthcare systems. Current treatments have limited effects due to the complex mechanism of SCI and poor neuron regeneration. Mesenchymal stem cells (MSCs) can promote the recovery of SCI nerve function. The therapeutic effect of MSCs is mainly related to exosomes secreted by MSCs, which have lower immunogenicity and an improved safety profile. This review summarizes the repair mechanism of mesenchymal stem cells-derived exosomes (MSCs-Exos) in SCI treatment and discusses the microRNAs related to SCI treatment based on MSCs-Exos and their mechanism of action.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Review Article

Key Findings

  • 1
    MSCs-Exos can reduce A1 neurotoxic astrocytes to improve the outcome of SCI. Wang et al. (88) found that intravenous administration of MSCs-Exos exerts anti-inflammatory and neuroprotective effects in a rat model of SCI
  • 2
    Several studies have shown that exosomes can promote angiogenesis after SCI. Zhang et al. (96) found that human placenta mesenchymal stem cells-derived exosomes (HP-MSCs-Exos) could promote tube formation by endothelial cells in vitro and new vessel formation in vivo
  • 3
    BMSC-Exos can inhibit neuronal apoptosis by activating the Wnt/β-catenin signaling pathway. EF-MSCs-Exos could decrease the expression level of the proapoptotic protein Bax and upregulate antiapoptotic proteins to reduce apoptosis after SCI

Research Summary

This review summarizes the role of MSCs-Exos in SCI treatment, including regulating immune responses, promoting angiogenesis, activating autophagy and inhibiting apoptosis, regulating the permeability of BSCB, promoting neuronal regeneration and axonal growth, and acting as delivery carriers. Current animal research has clarified that MSCs-Exos and their miRNAs in the treatment of SCI, including regulating immune responses, promoting angiogenesis, activating autophagy and inhibiting apoptosis, regulating the permeability of BSCB, promoting neuronal regeneration and axonal growth, and acting as delivery carriers. MSCs-Exos offers new possibilities for the treatment of SCI, and we expect that relevant clinical trials will be able to be conducted in the future, ultimately benefiting all of humanity.

Practical Implications

Therapeutic Potential

MSCs-Exos offer a promising cell-free therapy for SCI, with advantages over traditional stem cell therapy due to their biocompatibility, low toxicity, and ability to cross the blood-brain barrier.

Drug Delivery

Exosomes can be engineered as drug delivery vehicles for targeted delivery of therapeutic agents like miRNAs to the injured spinal cord, offering individualized therapy.

Research Directions

Further research is needed to optimize exosome isolation, purification, and amplification methods. Additionally, studies in primate models are essential to validate the efficacy of exosomes before clinical trials.

Study Limitations

  • 1
    Challenges in exosome isolation, purification, and amplification.
  • 2
    Limited research in primate SCI models.
  • 3
    Lack of targeted delivery mechanisms for exosomes.

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