Wang Yanying, Xu Ruojiao, Yan Yujia, He Binyu, Miao Chaoyi, Fang Yifeng, Wan Haitong, Zhou Guoying
The Second Clinical Medical College, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou 310053, China.
College of Life Science, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou 310053, China.
Biomedicines. 2024 Feb 2;12(2):353. doi: 10.3390/biomedicines12020353.
Ischemia reperfusion (I/R) is a common pathological process which occurs mostly in organs like the heart, brain, kidney, and lung. The injury caused by I/R gradually becomes one of the main causes of fatal diseases, which is an urgent clinical problem to be solved. Although great progress has been made in therapeutic methods, including surgical, drug, gene therapy, and transplant therapy for I/R injury, the development of effective methods to cure the injury remains a worldwide challenge. In recent years, exosomes have attracted much attention for their important roles in immune response, antigen presentation, cell migration, cell differentiation, and tumor invasion. Meanwhile, exosomes have been shown to have great potential in the treatment of I/R injury in organs. The study of the exosome-mediated signaling pathway can not only help to reveal the mechanism behind exosomes promoting reperfusion injury recovery, but also provide a theoretical basis for the clinical application of exosomes. Here, we review the research progress in utilizing various exosomes from different cell types to promote the healing of I/R injury, focusing on the classical signaling pathways such as PI3K/Akt, NF-κB, Nrf2, PTEN, Wnt, MAPK, toll-like receptor, and AMPK. The results suggest that exosomes regulate these signaling pathways to reduce oxidative stress, regulate immune responses, decrease the expression of inflammatory cytokines, and promote tissue repair, making exosomes a competitive emerging vector for treating I/R damage in organs.
缺血再灌注（I/R）是一种常见的病理过程，主要发生在心脏、大脑、肾脏和肺等器官。I/R引起的损伤逐渐成为致命疾病的主要原因之一，这是一个亟待解决的临床问题。尽管在治疗方法上取得了很大进展，包括针对I/R损伤的手术、药物、基因治疗和移植治疗，但开发有效的损伤治疗方法仍然是一项全球性挑战。近年来，外泌体因其在免疫反应、抗原呈递、细胞迁移、细胞分化和肿瘤侵袭中的重要作用而备受关注。同时，外泌体已被证明在器官I/R损伤的治疗中具有巨大潜力。对外泌体介导的信号通路的研究不仅有助于揭示外泌体促进再灌注损伤恢复的机制，还可为外泌体的临床应用提供理论依据。在此，我们综述了利用不同细胞类型的各种外泌体促进I/R损伤愈合的研究进展，重点关注PI3K/Akt、NF-κB、Nrf2、PTEN、Wnt、MAPK、Toll样受体和AMPK等经典信号通路。结果表明，外泌体通过调节这些信号通路来减轻氧化应激、调节免疫反应、降低炎性细胞因子的表达并促进组织修复，使外泌体成为治疗器官I/R损伤的一种有竞争力的新兴载体。
