Division of General and Trauma Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Division of Hematology-Oncology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Leukoc Biol. 2022 Jan;111(1):93-111. doi: 10.1002/JLB.3MIR0621-298R. Epub 2021 Sep 17.
Traumatic injury is a major cause of morbidity and mortality worldwide, despite significant advances in treatments. Most deaths occur either very early, through massive head trauma/CNS injury or exsanguination (despite advances in transfusion medicine), or later after injury often through multiple organ failure and secondary infection. Extracellular vesicles (EVs) are known to increase in the circulation after trauma and have been used to limited extent as diagnostic and prognostic markers. More intriguingly, EVs are now being investigated as both causes of pathologies post trauma, such as trauma-induced coagulopathy, and as potential treatments. In this review, we highlight what is currently known about the role and effects of EVs in various aspects of trauma, as well as exploring current literature from investigators who have begun to use EVs therapeutically to alter the physiology and pathology of traumatic insults. The potential effectiveness of using EVs therapeutically in trauma is supported by a large number of experimental studies, but there is still some way to go before we understand the complex effects of EVs in what is already a complex disease process.
创伤是全球发病率和死亡率的主要原因，尽管在治疗方面取得了重大进展。大多数死亡要么发生得很早，由于头部创伤/中枢神经系统损伤或出血（尽管输血医学取得了进步），要么发生在受伤后很久，通常是由于多器官衰竭和继发感染。创伤后循环中细胞外囊泡（EVs）的含量增加，并且已在一定程度上被用作诊断和预后标志物。更有趣的是，EVs 现在被认为是创伤后病理的原因，如创伤诱导的凝血功能障碍，以及作为潜在的治疗方法。在这篇综述中，我们重点介绍了目前已知的 EVs 在创伤各个方面的作用和影响，以及探讨了一些研究者的最新文献，这些研究者已经开始使用 EVs 进行治疗，以改变创伤性损伤的生理学和病理学。大量的实验研究支持了使用 EVs 进行治疗的有效性，但在我们了解 EVs 在已经复杂的疾病过程中的复杂作用之前，还有很长的路要走。
