Division of Pulmonology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Int J Mol Sci. 2020 Mar 27;21(7):2318. doi: 10.3390/ijms21072318.
Multipotent mesenchymal stem cells (MSCs) possess regenerative properties and have been shown to improve outcomes and survival in acute and chronic lung diseases, but there have been some safety concerns raised related to MSC-based therapy. Subsequent studies have demonstrated that many of the regenerative effects of MSCs can be attributed to the MSC-derived secretome, which contains soluble factors and extracellular vesicles (EVs). MSC-derived extracellular vesicles (MSC-derived EVs) replicate many of the beneficial effects of MSCs and contain a variety of bioactive factors that are transferred to recipient cells, mediating downstream signaling. MSC-derived EV therapy holds promise as a safe and effective treatment for pulmonary disease, but there remain many scientific and clinical questions that will need to be addressed before EVs are widely applied as a therapy. To date, the use of MSC-derived EVs as a treatment for lung disease has been conducted primarily in in vitro or pre-clinical animal models. In this review, we will discuss the current published research investigating the use of EVs as a potential therapeutic for acute lung injury/acute respiratory distress syndrome (ALI/ARDS), bronchopulmonary dysplasia (BPD), idiopathic pulmonary fibrosis (IPF), pulmonary arterial hypertension (PAH), asthma, and silicosis.
多能间充质干细胞（MSCs）具有再生特性，已被证明可改善急性和慢性肺部疾病的预后和存活率，但基于 MSC 的治疗存在一些安全性问题。随后的研究表明，MSCs 的许多再生作用可以归因于 MSC 来源的分泌组，其中包含可溶性因子和细胞外囊泡（EVs）。MSC 衍生的细胞外囊泡（MSC 衍生的 EVs）复制了 MSCs 的许多有益作用，并包含多种生物活性因子，这些因子被转移到受体细胞中，介导下游信号转导。MSC 衍生的 EV 治疗作为一种治疗肺部疾病的安全有效的方法具有广阔的前景，但在 EV 广泛应用于治疗之前，仍有许多科学和临床问题需要解决。迄今为止，MSC 衍生的 EV 作为肺部疾病治疗的用途主要在体外或临床前动物模型中进行了研究。在这篇综述中，我们将讨论目前关于 EV 作为急性肺损伤/急性呼吸窘迫综合征（ALI/ARDS）、支气管肺发育不良（BPD）、特发性肺纤维化（IPF）、肺动脉高压（PAH）、哮喘和矽肺的潜在治疗方法的研究。
