Department of Neurosurgery, General Hospital of Western Theater Command, Chengdu 610083, China.
Department of Anesthesiology, General Hospital of Western Theater Command, Chengdu 610083, China.
Exp Neurol. 2022 Jun;352:114026. doi: 10.1016/j.expneurol.2022.114026. Epub 2022 Feb 25.
Traumatic brain injury (TBI) is a leading cause of brain impairment, resulting in acute neural impairment and chronic long-term disability worldwide. Until now, no therapeutics developed can improve the neurological recovery and clinical prognosis of TBI. Latest studies have indicated that the cell-based therapy can improve neurological recovery by promoting intrinsic neurogenesis and neurite growth after TBI in animal experiments and clinical researches. However, subsequent studies have further demonstrated that the benefits of cell-based therapy are mediated by exosomes released from the administered cells, and microRNAs (miRNAs) cargos in exosomes are largely responsible for the therapeutic effects. Moreover, accumulating studies have found that exosomal miRNAs not only play key roles in the pathophysiological process of TBI, but also act as prominent candidates for the neurorestorative therapy for TBI. These evidences indicate that exosomal miRNAs might have great potential in the neurorestorative therapy for TBI. In this review, we will discuss the latest advances about exosomal miRNAs in the brain and the role of exosomal miRNAs in the neurorestorative therapy for TBI. And, we will investigate the possible mechanisms of exosomal miRNAs therapy for TBI, as well as the opportunities and challenges in the translation of exosomal miRNAs therapy to clinical applications for TBI.
创伤性脑损伤(TBI)是导致全球脑损伤的主要原因,导致急性神经损伤和慢性长期残疾。到目前为止,还没有开发出的治疗方法可以改善 TBI 的神经恢复和临床预后。最新研究表明,细胞疗法可以通过促进 TBI 后动物实验和临床研究中的内源性神经发生和神经突生长来改善神经恢复。然而,随后的研究进一步表明,细胞疗法的益处是由给予细胞释放的外泌体介导的,而外泌体中的 microRNAs(miRNAs)载运物在很大程度上负责治疗效果。此外,越来越多的研究发现,外泌体 miRNA 不仅在 TBI 的病理生理过程中发挥关键作用,而且作为 TBI 神经修复治疗的突出候选物。这些证据表明,外泌体 miRNA 可能在 TBI 的神经修复治疗中有很大的潜力。在这篇综述中,我们将讨论外泌体 miRNA 在大脑中的最新进展以及外泌体 miRNA 在 TBI 神经修复治疗中的作用。我们将研究外泌体 miRNA 治疗 TBI 的可能机制,以及将外泌体 miRNA 治疗转化为 TBI 临床应用的机遇和挑战。