Lim Young-Ju, Jung Gyeong Na, Park Wook-Tae, Seo Min-Soo, Lee Gun Woo
Department of Orthopedic Surgery, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.
Department of Veterinary Tissue Engineering, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea.
Front Cell Dev Biol. 2023 Mar 22;11:1151357. doi: 10.3389/fcell.2023.1151357. eCollection 2023.
Neural diseases such as compressive, congenital, and traumatic injuries have diverse consequences, from benign mild sequelae to severe life-threatening conditions with associated losses of motor, sensory, and autonomic functions. Several approaches have been adopted to control neuroinflammatory cascades. Traditionally, mesenchymal stem cells (MSCs) have been regarded as therapeutic agents, as they possess growth factors and cytokines with potential anti-inflammatory and regenerative effects. However, several animal model studies have reported conflicting outcomes, and therefore, the role of MSCs as a regenerative source for the treatment of neural pathologies remains debatable. In addition, issues such as heterogeneity and ethical issues limited their use as therapeutic agents. To overcome the obstacles associated with the use of traditional agents, we explored the therapeutic potentials of extracellular vesicles (EVs), which contain nucleic acids, functional proteins, and bioactive lipids, and play crucial roles in immune response regulation, inflammation reduction, and cell-to-cell communication. EVs may surpass MSCs in size issue, immunogenicity, and response to the host environment. However, a comprehensive review is required on the therapeutic potential of EVs for the treatment of neural pathologies. In this review, we discuss the action mechanism of EVs, their potential for treating neural pathologies, and future perspectives regarding their clinical applications.
诸如压迫性、先天性和创伤性损伤等神经疾病会产生各种各样的后果，从良性轻度后遗症到严重的危及生命的情况，同时伴有运动、感觉和自主神经功能丧失。已经采取了几种方法来控制神经炎症级联反应。传统上，间充质干细胞（MSCs）被视为治疗剂，因为它们拥有具有潜在抗炎和再生作用的生长因子和细胞因子。然而，一些动物模型研究报告了相互矛盾的结果，因此，MSCs作为治疗神经病理学的再生来源的作用仍然存在争议。此外，异质性和伦理问题等限制了它们作为治疗剂的使用。为了克服与使用传统药物相关的障碍，我们探索了细胞外囊泡（EVs）的治疗潜力，EVs含有核酸、功能蛋白和生物活性脂质，在免疫反应调节、减轻炎症和细胞间通讯中发挥关键作用。EVs在大小问题、免疫原性和对宿主环境的反应方面可能优于MSCs。然而，需要对EVs治疗神经病理学的治疗潜力进行全面综述。在这篇综述中，我们讨论了EVs的作用机制、它们治疗神经病理学的潜力以及它们临床应用的未来前景。
