Bhimani Abhiraj D, Kalagara Roshini, Chennareddy Susmita, Kellner Christopher P
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Clin Neurosci. 2022 Nov;105:58-65. doi: 10.1016/j.jocn.2022.08.025. Epub 2022 Sep 7.
Vasospasm is a common complication following subarachnoid hemorrhage (SAH), causing increased ischemia and tissue injury, and is implicated as a major risk factor for poor outcomes. The success of current treatments for vasospasm is limited, with limited efficacy and unclear clinical benefits. Exosomes, vesicles that carry small molecules such as miRNA, have been theorized as a potential vasospasm treatment. In this study, we aim to survey the current literature discussing the role of exosomes in the setting of SAH.
Following PRISMA guidelines, we performed a scoping review evaluating the role of exosomes in the treatment of SAH. The search was conducted using PubMed and Scopus, and all original research papers studying exosomal profiles of SAH research subjects or SAH therapy were eligible for inclusion.
After screening and full text review, seven papers were selected for final inclusion. Of these, two studies analyzed the expression profile of endogenous exosomes after SAH. Four papers identified and characterized miRNA-based exosomal therapies to attenuate early brain injury (EBI) after SAH. One paper discussed the role of protein overexpression in exosome delivery of miRNA for EBI after SAH. Interestingly, all identified papers studying exosomal therapy demonstrated anti-apoptotic or anti-inflammatory effects of miRNA exosomes acting via the BDNF/TrkB/CREB or HDAC3/NF-κB pathways.
Identified studies demonstrate potential neuroprotective benefits of miRNA-based exosomal treatment of EBI and SAH. Findings warrant further research investigating the anti-inflammatory and anti-apoptotic role of exosomal miRNA delivery in SAH models, specifically targeting the common pathway identified by the authors.
血管痉挛是蛛网膜下腔出血（SAH）后的常见并发症，会导致缺血增加和组织损伤，并且被认为是预后不良的主要危险因素。目前治疗血管痉挛的方法成效有限，疗效欠佳且临床益处不明确。外泌体是携带如miRNA等小分子的囊泡，理论上被认为是一种潜在的血管痉挛治疗方法。在本研究中，我们旨在综述当前讨论外泌体在SAH情况下作用的文献。
遵循PRISMA指南，我们进行了一项范围综述，评估外泌体在SAH治疗中的作用。使用PubMed和Scopus进行检索，所有研究SAH研究对象的外泌体特征或SAH治疗的原始研究论文均符合纳入标准。
经过筛选和全文审查，最终纳入了七篇论文。其中，两项研究分析了SAH后内源性外泌体的表达谱。四篇论文鉴定并表征了基于miRNA的外泌体疗法，以减轻SAH后的早期脑损伤（EBI）。一篇论文讨论了蛋白质过表达在SAH后miRNA外泌体递送用于EBI中的作用。有趣的是，所有鉴定出的研究外泌体疗法的论文都证明了miRNA外泌体通过BDNF/TrkB/CREB或HDAC3/NF-κB途径发挥的抗凋亡或抗炎作用。
已鉴定的研究表明基于miRNA的外泌体治疗EBI和SAH具有潜在的神经保护益处。这些发现值得进一步研究，以探讨外泌体miRNA递送在SAH模型中的抗炎和抗凋亡作用，特别是针对作者确定的共同途径。
