Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Kasr El Aini St., Cairo, 11562, Egypt.
Department of Pharmacy and Biotechnology, Faculty of Medicine and Health Sciences, University of Palestine, Gaza, Palestine.
Tissue Eng Regen Med. 2022 Dec;19(6):1129-1146. doi: 10.1007/s13770-022-00469-x. Epub 2022 Jul 22.
Cardiovascular diseases (CVDs) remain a major health concern worldwide, where mesenchymal stem cells (MSCs) therapy gives great promise in their management through their regenerative and paracrine actions. In recent years, many studies have shifted from the use of transplanted stem cells to their secreted exosomes for the management of various CVDs and cardiovascular-related diseases including atherosclerosis, stroke, myocardial infarction, heart failure, peripheral arterial diseases, and pulmonary hypertension. In different models, MSC-derived exosomes have shown beneficial outcomes similar to cell therapy concerning regenerative and neovascular actions in addition to their anti-apoptotic, anti-remodeling, and anti-inflammatory actions. Compared with their parent cells, exosomes have also demonstrated several advantages, including lower immunogenicity and no risk of tumor formation. However, the maintenance of stability and efficacy of exosomes after in vivo transplantation is still a major concern in their clinical application. Recently, new approaches have been developed to enhance their efficacy and stability including their preconditioning before transplantation, use of genetically modified MSC-derived exosomes, or their utilization as a targeted drug delivery system. Herein, we summarized the use of MSC-derived exosomes as therapies in different CVDs in addition to recent advances for the enhancement of their efficacy in these conditions.
心血管疾病（CVDs）仍然是全球主要的健康关注点，间充质干细胞（MSCs）疗法通过其再生和旁分泌作用，为 CVD 的管理带来了很大的希望。近年来，许多研究已将注意力从移植干细胞转移到其分泌的外泌体，以用于管理各种 CVD 和心血管相关疾病，包括动脉粥样硬化、中风、心肌梗死、心力衰竭、外周动脉疾病和肺动脉高压。在不同的模型中，MSC 衍生的外泌体在再生和新生血管作用方面显示出与细胞疗法相似的有益效果，此外还具有抗细胞凋亡、抗重塑和抗炎作用。与亲代细胞相比，外泌体还具有较低的免疫原性和无肿瘤形成的风险。然而，外泌体在体内移植后的稳定性和功效的维持仍然是其临床应用中的一个主要关注点。最近，已经开发出一些新方法来提高其功效和稳定性，包括移植前的预处理、使用基因修饰的 MSC 衍生的外泌体，或利用它们作为靶向药物传递系统。本文总结了 MSC 衍生的外泌体在不同 CVD 中的治疗用途，以及在这些情况下提高其疗效的最新进展。
