Perde-Schrepler Maria, Brie Ioana, Maniu Alma
Iuliu Hatieganu, University of Medicine and Pharmacy, Department of Oto-Rhyno-Laryngology, Cluj-Napoca, Romania; Ion Chiricuta, Institute of Oncology, Cluj-Napoca, Romania.
Ion Chiricuta, Institute of Oncology, Cluj-Napoca, Romania.
Biomol Biomed. 2025 Mar 6. doi: 10.17305/bb.2025.11517.
Sensorineural hearing loss (SNHL) can result from various factors, including ototoxic drugs (such as aminoglycosides and chemotherapeutic agents), prolonged exposure to intense sound, and autoimmune or genetic disorders. In adult mammals, the loss of sensory cells in the cochlea is irreversible due to their lack of regenerative capacity. Current treatment options include hearing aids for mild to moderate hearing loss, which rely on residual hearing, and cochlear implants for severe cases, which provide limited auditory recovery while leading to the loss of any remaining natural hearing. Stem cell therapies, particularly those involving mesenchymal stem cells (MSCs), are being increasingly explored in regenerative medicine. MSCs are multipotent cells capable of differentiating into mesodermal lineage cells and possess immunomodulatory and regenerative properties, making them potential candidates for SNHL treatment. However, their administration carries risks, including unwanted differentiation, immune system activation, and potential tumorigenic effects. Exosomes, extracellular vesicles in the nanometer size range, are secreted by most eukaryotic cells. These vesicles, which have a double lipid membrane and contain genomic and proteomic material, play a crucial role in intercellular communication. Exosomes derived from MSCs exhibit similar biological functions to their parent cells but with significantly lower risks, as they do not trigger immune responses or pose oncological concerns. This paper aims to review current knowledge on the use of MSCs and MSC-derived exosomes for inner ear sensory cell regeneration and explore their potential for clinical applications.
感音神经性听力损失（SNHL）可由多种因素引起，包括耳毒性药物（如氨基糖苷类和化疗药物）、长期暴露于高强度声音以及自身免疫或遗传疾病。在成年哺乳动物中，由于耳蜗中的感觉细胞缺乏再生能力，其损失是不可逆的。目前的治疗选择包括用于轻度至中度听力损失的助听器，其依赖于残余听力，以及用于严重病例的人工耳蜗，其虽能提供有限的听觉恢复，但会导致任何剩余自然听力的丧失。干细胞疗法，特别是涉及间充质干细胞（MSCs）的疗法，正在再生医学中得到越来越多的探索。间充质干细胞是能够分化为中胚层谱系细胞的多能细胞，并具有免疫调节和再生特性，使其成为感音神经性听力损失治疗的潜在候选者。然而，它们的给药存在风险，包括不必要的分化、免疫系统激活和潜在的致瘤作用。外泌体是纳米尺寸范围内的细胞外囊泡，由大多数真核细胞分泌。这些具有双脂质膜并包含基因组和蛋白质组物质的囊泡在细胞间通讯中起关键作用。源自间充质干细胞的外泌体表现出与其亲本细胞相似的生物学功能，但风险显著降低，因为它们不会引发免疫反应或引起肿瘤学问题。本文旨在综述关于使用间充质干细胞和间充质干细胞衍生外泌体进行内耳感觉细胞再生的现有知识，并探讨它们在临床应用中的潜力。
