Ravi Mythili Vijay Murali, Rajendran Ramya Lakshmi, Arun Raksa, Thasma Loganathbabu Vasanth Kanth, Reyaz Danyal, Nagarajan ArulJothi Kandasamy, Ahn Byeong-Cheol, Gangadaran Prakash
Integrative Genetics and Molecular Oncology Group, Department of Genetic Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Chengalpattu 603203, Tamil Nadu, India.
Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea.
Bioengineering (Basel). 2025 Jan 20;12(1):92. doi: 10.3390/bioengineering12010092.
Critical limb ischemia (CLI) poses a substantial and intricate challenge in vascular medicine, necessitating the development of innovative therapeutic strategies to address its multifaceted pathophysiology. Conventional revascularization approaches often fail to adequately address the complexity of CLI, necessitating the identification of alternative methodologies. This review explores uncharted territory beyond traditional therapies, focusing on the potential of two distinct yet interrelated entities: cell-derived extracellular vesicles (EVs) and artificial nanovesicles. Cell-derived EVs are small membranous structures naturally released by cells, and artificial nanovesicles are artificially engineered nanosized vesicles. Both these vesicles represent promising avenues for therapeutic intervention. They act as carriers of bioactive cargo, including proteins, nucleic acids, and lipids, that can modulate intricate cellular responses associated with ischemic tissue repair and angiogenesis. This review also assesses the evolving landscape of CLI revascularization through the unique perspective of cell-derived EVs and artificial nanovesicles. The review spans the spectrum from early preclinical investigations to the latest translational advancements, providing a comprehensive overview of the current state of research in this emerging field. These groundbreaking vesicle therapies hold immense potential for revolutionizing CLI treatment paradigms.
严重肢体缺血（CLI）在血管医学中构成了重大且复杂的挑战，需要开发创新的治疗策略来应对其多方面的病理生理学。传统的血管重建方法往往无法充分应对CLI的复杂性，因此需要确定替代方法。本综述探索了传统疗法之外的未知领域，重点关注两个不同但相互关联的实体：细胞衍生的细胞外囊泡（EVs）和人工纳米囊泡的潜力。细胞衍生的EVs是细胞自然释放的小膜结构，人工纳米囊泡是人工工程化的纳米级囊泡。这两种囊泡都代表了有前景的治疗干预途径。它们作为生物活性物质的载体，包括蛋白质、核酸和脂质，可调节与缺血组织修复和血管生成相关的复杂细胞反应。本综述还通过细胞衍生的EVs和人工纳米囊泡的独特视角评估了CLI血管重建的不断发展的格局。该综述涵盖了从早期临床前研究到最新转化进展的范围，全面概述了这一新兴领域的当前研究状况。这些开创性的囊泡疗法在彻底改变CLI治疗模式方面具有巨大潜力。
