Farahzadi Raheleh, Fathi Ezzatollah, Valipour Behnaz, Ghaffary Saba
Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Cardiol Heart Vasc. 2024 Mar 30;52:101399. doi: 10.1016/j.ijcha.2024.101399. eCollection 2024 Jun.
Heart failure is a root cause of morbidity and mortality worldwide. Due to the limited regenerative capacity of the heart following myocardial injury, stem cell-based therapies have been considered a hopeful approach for improving cardiac regeneration. In recent years, different kinds of cell products have been investigated regarding their potential to treat patients with heart failure. Despite special attention to cell therapy and its products, therapeutic efficacy has been disappointing, and clinical application is not affordable. In the past few years, a subset of small extracellular vehicles (EVs), commonly known as "exosomes," was reported to grant regenerative and cardioprotective signals at a value similar to their donor cells. The conceptual advantage is that they may be ideally used without evoking a relevant recipient immune response or other adverse effects associated with viable cells. The evidence related to their beneficial effects in animal models of heart failure is rapidly growing. However, there is remarkable heterogeneity regarding source cells, isolation process, effective dosage, and delivery mode. This brief review will focus on the latest research and debates on regenerative potential and cardiac repair of exosomes from different sources, such as cardiac/non-cardiac stem, somatic cells, and progenitor cells. Overall, the current state of research on exosomes as an experimental therapy for heart diseases will be discussed.
心力衰竭是全球发病和死亡的根本原因。由于心肌损伤后心脏的再生能力有限，基于干细胞的疗法被认为是改善心脏再生的一种有希望的方法。近年来，人们对不同种类的细胞产品治疗心力衰竭患者的潜力进行了研究。尽管对细胞疗法及其产品给予了特别关注，但其治疗效果却令人失望，且临床应用成本过高。在过去几年中，据报道，一类称为“外泌体”的小细胞外囊泡能传递与供体细胞类似的再生和心脏保护信号。其概念优势在于，它们在使用时可能不会引发相关的受体免疫反应或与活细胞相关的其他不良反应。关于它们在心力衰竭动物模型中的有益作用的证据正在迅速增加。然而，在来源细胞、分离过程、有效剂量和递送方式方面存在显著的异质性。这篇简短的综述将聚焦于不同来源（如心脏/非心脏干细胞、体细胞和祖细胞）的外泌体在再生潜力和心脏修复方面的最新研究及争论。总体而言，将讨论外泌体作为心脏病实验性疗法的当前研究状况。
