Lee Byung-Chul, Kang Insung, Yu Kyung-Rok
Translational Stem Cell Biology Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20892, USA.
Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD 20892, USA.
J Clin Med. 2021 Feb 11;10(4):711. doi: 10.3390/jcm10040711.
Identification of the immunomodulatory and regenerative properties of mesenchymal stem cells (MSCs) have made them an attractive alternative therapeutic option for diseases with no effective treatment options. Numerous clinical trials have followed; however, issues such as infusional toxicity and cellular rejection have been reported. To address these problems associated with cell-based therapy, MSC exosome therapy was developed and has shown promising clinical outcomes. MSC exosomes are nanosized vesicles secreted from MSCs and represent a non-cellular therapeutic agent. MSC exosomes retain therapeutic features of the cells from which they originated including genetic material, lipids, and proteins. Similar to MSCs, exosomes can induce cell differentiation, immunoregulation, angiogenesis, and tumor suppression. MSC exosomes have therefore been employed in several experimental models and clinical studies. Here, we review the therapeutic potential of MSC-derived exosomes and summarize currently ongoing clinical trials according to disease type. In addition, we propose several functional enhancement strategies for the effective clinical application of MSC exosome therapy.
间充质干细胞（MSCs）免疫调节和再生特性的发现，使其成为治疗尚无有效治疗方案疾病的一种有吸引力的替代治疗选择。随后进行了大量临床试验；然而，已有输注毒性和细胞排斥等问题的报道。为了解决与细胞疗法相关的这些问题，人们开发了MSC外泌体疗法，并已显示出有前景的临床结果。MSC外泌体是MSCs分泌的纳米级囊泡，代表一种非细胞治疗剂。MSC外泌体保留了其来源细胞的治疗特性，包括遗传物质、脂质和蛋白质。与MSCs类似，外泌体可诱导细胞分化、免疫调节、血管生成和肿瘤抑制。因此，MSC外泌体已被应用于多个实验模型和临床研究中。在此，我们综述了MSC来源外泌体的治疗潜力，并根据疾病类型总结了目前正在进行的临床试验。此外，我们提出了几种功能增强策略，以有效临床应用MSC外泌体疗法。
