Immunology Division, Department of Internal Medicine and Hematology, Semmelweis University, Szentkirályi Street 46, 1088 Budapest, Hungary.
Cells. 2022 Jul 26;11(15):2300. doi: 10.3390/cells11152300.
Immune-mediated inflammatory diseases (IMIDs) encompass several entities such as "classic" autoimmune disorders or immune-mediated diseases with autoinflammatory characteristics. Adult stem cells including mesenchymal stem cells (MSCs) are by far the most commonly used type in clinical practice. However, due to the possible side effects of MSC-based treatments, there is an increase in interest in the MSC-secretome (containing large extracellular vesicles, microvesicles, and exosomes) as an alternative therapeutic option in IMIDs. A wide spectrum of MSC-secretome-related biological activities has been proven thus far including anti-inflammatory, anti-apoptotic, and immunomodulatory properties. In comparison with MSCs, the secretome is less immunogenic but exerts similar biological actions, so it can be considered as an ideal cell-free therapeutic alternative. Additionally, since the composition of the MSC-secretome can be engineered, for a future perspective, it could also be viewed as part of a potential delivery system within nanomedicine, allowing us to specifically target dysfunctional cells or tissues. Although many encouraging results from pre-clinical studies have recently been obtained that strongly support the application of the MSC-secretome in IMIDs, human studies with MSC-secretome administration are still in their infancy. This article reviews the immunomodulatory effects of the MSC-secretome in IMIDs and provides insight into the interpretation of its beneficial biological actions.
免疫介导的炎症性疾病（IMIDs）包括多种实体，如“经典”自身免疫性疾病或具有自身炎症特征的免疫介导性疾病。成体干细胞，包括间充质干细胞（MSCs），是目前临床实践中最常用的类型。然而，由于基于 MSC 的治疗可能存在副作用，因此人们对 MSC 分泌组（包含大型细胞外囊泡、微泡和外泌体）作为 IMIDs 的替代治疗选择越来越感兴趣。迄今为止，已经证明 MSC 分泌组具有广泛的生物学活性，包括抗炎、抗凋亡和免疫调节特性。与 MSC 相比，分泌组的免疫原性较低，但具有相似的生物学作用，因此可以被认为是一种理想的无细胞治疗替代物。此外，由于 MSC 分泌组的组成可以进行工程设计，因此从未来的角度来看，它也可以被视为纳米医学中潜在输送系统的一部分，使我们能够专门针对功能失调的细胞或组织。尽管最近从临床前研究中获得了许多令人鼓舞的结果，强烈支持 MSC 分泌组在 IMIDs 中的应用，但 MSC 分泌组给药的人体研究仍处于起步阶段。本文综述了 MSC 分泌组在 IMIDs 中的免疫调节作用，并深入探讨了其有益的生物学作用的解释。
