Department of Cardiology, Affiliated Hospital of Guilin Medical University, 15 Lequn Road, Guilin, 541000, China.
Department of Rehabilitation Medicine, The Third Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China.
J Cardiovasc Transl Res. 2023 Oct;16(5):1085-1098. doi: 10.1007/s12265-023-10401-w. Epub 2023 Jun 7.
Ischemic cardiomyopathy is treated mainly with thrombolytic drugs, percutaneous coronary intervention, and coronary artery bypass grafting to recanalize blocked vessels. Myocardial ischemia-reperfusion injury (MIRI) is an unavoidable complication of obstructive revascularization. Compared with those of myocardial ischemic injury, few effective therapeutic options are available for MIRI treatment. The pathophysiological mechanisms of MIRI involve the inflammatory response, the immune response, oxidative stress, apoptosis, intracellular Ca overload, and cardiomyocyte energy metabolism. These mechanisms exacerbate MIRI. Mesenchymal stem cell-derived exosomes (MSC-EXOs) can alleviate MIRI through these mechanisms and, to some extent, prevent the limitations caused by direct MSC administration. Therefore, using MSC-EXOs instead of MSCs to treat MIRI is a potentially beneficial cell-free treatment strategy. In this review, we describe the mechanism of action of MSC-EXO-derived noncoding RNAs in the treatment of MIRI and discuss the advantages and limitations of this strategy, as well as possible future research directions.
缺血性心肌病主要通过溶栓药物、经皮冠状动脉介入治疗和冠状动脉旁路移植术来疏通阻塞的血管进行治疗。心肌缺血再灌注损伤（MIRI）是阻塞性血运重建不可避免的并发症。与心肌缺血损伤相比，MIRI 的治疗方法非常有限。MIRI 的病理生理机制涉及炎症反应、免疫反应、氧化应激、细胞凋亡、细胞内 Ca 超载和心肌细胞能量代谢。这些机制加剧了 MIRI。间充质干细胞衍生的外泌体（MSC-EXOs）可以通过这些机制缓解 MIRI，并在一定程度上防止直接给予 MSC 带来的限制。因此，使用 MSC-EXO 而非 MSC 来治疗 MIRI 是一种有前途的无细胞治疗策略。在本综述中，我们描述了 MSC-EXO 衍生的非编码 RNA 在治疗 MIRI 中的作用机制，并讨论了这种策略的优缺点以及可能的未来研究方向。
