Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvanthari Nagar, Puducherry, India.
Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvanthari Nagar, Puducherry, India.
Brain Res. 2023 Mar 15;1803:148228. doi: 10.1016/j.brainres.2022.148228. Epub 2022 Dec 30.
Exosome therapy has been theorized to be safer, more effective, and less cumbersome in replacing stem cell therapies for tissue repair and regeneration. There remains considerable uncertainty on whether exosome therapy is efficacious and safe for recovery from brain injury due to cerebral infarction. There is growing consensus that systematic reviews of data, from preclinical studies which yielded conflicting and confusing results, can provide valuable directions for novel therapeutic options for several clinical conditions. This study systematically evaluated the efficacy of exosome therapy in ischemic stroke in preclinical studies in rodent models.
We reviewed existing literature on exosome therapy in rodent stroke models from various databases, and reviewed the interventional measures, and outcome measures systematically, with changes in the infarct volume and functional scores as outcome parameters. Seventeen homogeneous studies were found qualitatively acceptable for meta-analysis. The study used software RevMan 5.3 to conduct the meta-analysis (PROSPERO Register Number: CRD42022314138) RESULTS: Compared to placebo, exosomes treated ischemic stroke models showed significantly reduced brain infarct volume and improved functional recovery on days 7 and 28. Though there are no safety concerns reported in any preclinical studies, there is insufficient data to make robust conclusions on the therapy's safety.
Therapy with subcellular exosomes is a promising treatment to be explored further in animal ischemic stroke models to arrive at robust conclusions for its safety and therapeutic dosage. This must precede Phase I and II- human randomized clinical trials to establish the safety and proof of concept of efficacy of exosome therapy in human ischemic stroke.
外泌体疗法被认为在替代干细胞疗法进行组织修复和再生方面更安全、更有效、且不那么繁琐。由于脑梗死导致的脑损伤，外泌体疗法是否有效和安全仍然存在相当大的不确定性。越来越多的人认为，对产生相互矛盾和令人困惑结果的临床前研究数据进行系统评价，可以为几种临床情况的新治疗选择提供有价值的方向。本研究系统评估了外泌体疗法在啮齿动物模型缺血性中风中的疗效。
我们从各种数据库中回顾了外泌体疗法在啮齿动物中风模型中的现有文献，并系统地回顾了干预措施和结局测量，以梗死体积和功能评分的变化作为结局参数。定性上有 17 项同质研究可进行荟萃分析。该研究使用软件 RevMan 5.3 进行荟萃分析（PROSPERO 注册编号：CRD42022314138）。
与安慰剂相比，外泌体治疗缺血性中风模型可显著减少脑梗死体积，并在第 7 天和第 28 天改善功能恢复。虽然任何临床前研究都没有报告安全性问题，但关于该疗法的安全性仍缺乏足够的数据得出可靠的结论。
亚细胞外泌体疗法是一种很有前途的治疗方法，可以在动物缺血性中风模型中进一步探索，以得出其安全性和治疗剂量的可靠结论。这必须在 I 期和 II 期-人体随机临床试验之前进行，以确定外泌体疗法在人体缺血性中风中的安全性和疗效概念的证据。
