Biology Unit, Department of Experimental Medicine (DIMES), University of Genova, 16132 Genova, Italy.
Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Laboratories for Translational Research, Ente Ospedaliero Cantonale, CH-6500 Bellinzona, Switzerland.
Int J Mol Sci. 2024 Jun 4;25(11):6187. doi: 10.3390/ijms25116187.
Cardiovascular disease represents the foremost cause of mortality and morbidity worldwide, with a steadily increasing incidence due to the growth of the ageing population. Cardiac dysfunction leading to heart failure may arise from acute myocardial infarction (MI) as well as inflammatory- and cancer-related chronic cardiomyopathy. Despite pharmacological progress, effective cardiac repair represents an unmet clinical need, with heart transplantation being the only option for end-stage heart failure. The functional profiling of the biological activity of extracellular vesicles (EVs) has recently attracted increasing interest in the field of translational research for cardiac regenerative medicine. The cardioprotective and cardioactive potential of human progenitor stem/cell-derived EVs has been reported in several preclinical studies, and EVs have been suggested as promising paracrine therapy candidates for future clinical translation. Nevertheless, some compelling aspects must be properly addressed, including optimizing delivery strategies to meet patient needs and enhancing targeting specificity to the cardiac tissue. Therefore, in this review, we will discuss the most relevant aspects of the therapeutic potential of EVs released by human progenitors for cardiovascular disease, with a specific focus on the strategies that have been recently implemented to improve myocardial targeting and administration routes.
心血管疾病是全球范围内导致死亡和发病的首要原因，由于人口老龄化的增长，其发病率也在稳步上升。导致心力衰竭的心功能障碍可能源于急性心肌梗死（MI）以及炎症和癌症相关的慢性心肌病。尽管在药理学上取得了进展，但有效的心脏修复仍然是一个未满足的临床需求，心脏移植是终末期心力衰竭的唯一选择。细胞外囊泡（EVs）的生物学活性的功能分析最近在心脏再生医学的转化研究领域引起了越来越多的兴趣。在几项临床前研究中已经报道了人原代干细胞/细胞衍生的 EVs 的心脏保护和心脏活性潜能，并且 EVs 被认为是未来临床转化的有前途的旁分泌治疗候选物。然而，一些引人注目的方面必须得到妥善解决，包括优化输送策略以满足患者的需求并提高对心脏组织的靶向特异性。因此，在这篇综述中，我们将讨论人类祖细胞释放的 EVs 在心血管疾病中的治疗潜力的最相关方面，特别关注最近为提高心肌靶向性和给药途径而实施的策略。
