National Heart and Lung Institute, Imperial College London, London W12 0NN, UK.
Botucatu Medical School, Sao Paulo State University, 18618687 Botucatu, Brazil.
Biomolecules. 2020 May 2;10(5):707. doi: 10.3390/biom10050707.
Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity globally, representing approximately a third of all deaths every year. The greater part of these cases is represented by myocardial infarction (MI), or heart attack as it is better known, which occurs when declining blood flow to the heart causes injury to cardiac tissue. Mesenchymal stem cells (MSCs) are multipotent stem cells that represent a promising vector for cell therapies that aim to treat MI due to their potent regenerative effects. However, it remains unclear the extent to which MSC-based therapies are able to induce regeneration in the heart and even less clear the degree to which clinical outcomes could be improved. Exosomes, which are small extracellular vesicles (EVs) known to have implications in intracellular communication, derived from MSCs (MSC-Exos), have recently emerged as a novel cell-free vector that is capable of conferring cardio-protection and regeneration in target cardiac cells. In this review, we assess the current state of research of MSC-Exos in the context of MI. In particular, we place emphasis on the mechanisms of action by which MSC-Exos accomplish their therapeutic effects, along with commentary on the current difficulties faced with exosome research and the ongoing clinical applications of stem-cell derived exosomes in different medical contexts.
心血管疾病 (CVDs) 是全球范围内导致死亡和发病的主要原因，每年约占所有死亡人数的三分之一。这些病例中大部分是心肌梗死 (MI)，也就是我们通常所说的心脏病发作，它是由于流向心脏的血液减少导致心肌组织受损而发生的。间充质干细胞 (MSCs) 是多能干细胞，由于其强大的再生作用，它们是细胞治疗的有前途的载体，旨在治疗 MI。然而，目前尚不清楚基于 MSC 的治疗方法在多大程度上能够诱导心脏再生，甚至更不清楚临床结果能够在多大程度上得到改善。外泌体是一种已知在细胞内通讯中具有重要作用的小型细胞外囊泡 (EV)，来源于间充质干细胞 (MSC-Exos)，最近作为一种新型的无细胞载体出现，能够在靶心肌细胞中发挥心脏保护和再生作用。在这篇综述中，我们评估了 MSC-Exos 在 MI 背景下的研究现状。特别是，我们强调了 MSC-Exos 发挥治疗作用的作用机制，以及对外泌体研究当前面临的困难和干细胞衍生的外泌体在不同医学背景下的临床应用的评论。
