Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA.
Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA.
Mol Ther. 2018 Jul 5;26(7):1635-1643. doi: 10.1016/j.ymthe.2018.04.024. Epub 2018 May 3.
Myocardial disease is a leading cause of morbidity and mortality worldwide. Given the limited regenerative capacity of the human heart following myocardial injury, stem cell-based therapies have emerged as a promising approach for improving cardiac repair and function. The discovery of extracellular vesicles including exosomes as a key component of the beneficial function of stem cells has generated hope for their use to advance cell-based regenerative therapies for cardiac repair. Exosomes secreted from stem cells are membranous bionanovesicles, naturally loaded with various proteins, lipids, and nucleic acids. They have been found to have anti-apoptotic, anti-fibrotic, as well as pro-angiogenic effects, all of which are crucial to restore function of the damaged myocardium. In this brief review, we will focus on the latest research and debates on cardiac repair and regenerative potential of exosomes from a variety of sources such as cardiac and non-cardiac stem and progenitor cells, somatic cells, and body fluids. We will also highlight important barriers involved in translating these findings into developing clinically suitable exosome-based therapies.
心肌疾病是全球发病率和死亡率的主要原因。鉴于人类心脏在心肌损伤后再生能力有限，基于干细胞的疗法已成为改善心脏修复和功能的一种有前途的方法。细胞外囊泡（包括外泌体）作为干细胞有益功能的关键组成部分的发现，为利用它们推进基于细胞的心脏修复再生疗法带来了希望。干细胞分泌的外泌体是膜性生物纳米囊泡，天然负载有各种蛋白质、脂质和核酸。它们被发现具有抗细胞凋亡、抗纤维化以及促血管生成的作用，所有这些作用对于恢复受损心肌的功能都至关重要。在这篇简要综述中，我们将重点介绍来自各种来源（如心脏和非心脏干细胞和祖细胞、体细胞以及体液）的外泌体在心脏修复和再生潜力方面的最新研究和争论。我们还将重点介绍将这些发现转化为开发临床适用的外泌体疗法所涉及的重要障碍。
