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基于外泌体的再生康复治疗:神经疾病的破冰新途径。

Exosome-based regenerative rehabilitation: A novel ice breaker for neurological disorders.

机构信息

Department of Spine Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.

Department of Sport Medicine, Peking University Third Hospital, Beijing, China.

出版信息

Biomed Pharmacother. 2023 Dec 31;169:115920. doi: 10.1016/j.biopha.2023.115920. Epub 2023 Nov 22.

Abstract

Neurological disorders affect a large population, often leading to different levels of disability and resulting in decreased quality of life. Due to the limited recovery obtained from surgical procedures and other medical approaches, a large number of patients with prolonged dysfunction receive neurorehabilitation protocols to improve their neural plasticity and regeneration. However, the poor neural regeneration ability cannot effectively rebuild the tissue integrity and neural functional networks; consequently, the prognoses of neurorehabilitation remain undetermined. To increase the chances of neural regeneration and functional recovery for patients with neurological disorders, regenerative rehabilitation was introduced with combined regenerative medicine and neurorehabilitation protocols to repair neural tissue damage and create an optimized biophysical microenvironment for neural regeneration potential. With the deepening of exosome research, an increasing number of studies have found that the systemic therapeutic effects of neurorehabilitation approaches are mediated by exosomes released by physically stimulated cells, which provides new insight into rehabilitative mechanisms. Meanwhile, exosome therapy also serves as an alternative cell-free therapy of regenerative medicine that is applied in partnership with neurorehabilitation approaches and formulates exosome-based neurological regenerative rehabilitation. In this study, we review the current state of exosome-associated neurorehabilitation. On the one hand, we focus on presenting the varied mediating effects of exosomes in neurorehabilitation protocols of specific neurological pathologies; on the other hand, we discuss the diverse combinations of exosome therapies and neurorehabilitation approaches in the field of neurological regenerative rehabilitation, aiming to increase the awareness of exosome research and applications in the rehabilitation of neurological disorders.

摘要

神经系统疾病影响着庞大的人群,往往导致不同程度的残疾,降低生活质量。由于手术和其他医疗方法的恢复有限,大量长期功能障碍的患者接受神经康复方案,以改善其神经可塑性和再生。然而,较差的神经再生能力无法有效重建组织完整性和神经功能网络;因此,神经康复的预后仍不确定。为了增加神经系统疾病患者神经再生和功能恢复的机会,引入了再生康复,结合再生医学和神经康复方案,以修复神经组织损伤,并为神经再生潜力创造优化的生物物理微环境。随着外泌体研究的深入,越来越多的研究发现,神经康复方法的全身治疗效果是由物理刺激细胞释放的外泌体介导的,这为康复机制提供了新的见解。同时,外泌体治疗也作为再生医学的无细胞治疗替代方法,与神经康复方法联合应用,并制定基于外泌体的神经再生康复方案。在本研究中,我们综述了与外泌体相关的神经康复的现状。一方面,我们重点介绍了外泌体在特定神经病理的神经康复方案中的不同介导作用;另一方面,我们讨论了外泌体治疗与神经再生康复领域中神经康复方法的多种组合,旨在提高对外泌体在神经疾病康复中的研究和应用的认识。

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