Fu Xiaochen, Li Jia, Yang Shoujun, Jing Jiapeng, Zheng Qinzhi, Zhang Ting, Xu Zhuo
Department of Rehabilitation, China-Japan Union Hospital of Jilin University, Changchun, China.
Rehabilitation Therapeutics, School of Nursing, Jilin University, Changchun, China.
Front Cell Neurosci. 2025 Apr 7;19:1536028. doi: 10.3389/fncel.2025.1536028. eCollection 2025.
Stroke is characterized with high morbidity, mortality and disability all over the world, and one of its core pathologies is blood-brain barrier (BBB) dysfunction. BBB plays a crucial physiological role in protecting brain tissues and maintaining homeostasis in central nervous system (CNS). BBB dysfunction serves as a key factor in the development of cerebral edema, inflammation, and further neurological damage in stroke patients. Currently, stem cells and their derived exosomes have shown remarkable potential in repairing the damaged BBB and improving neurological function after stroke. Stem cells repair the integrity of BBB through anti-inflammatory, antioxidant, angiogenesis and regulation of intercellular signaling mechanisms, while stem cell-derived exosomes, as natural nanocarriers, further enhance the therapeutic effect by carrying active substances such as proteins, RNAs and miRNAs. This review will present the latest research advances in stem cells and their exosomes in stroke treatment, as well as the challenges of cell source, transplantation timing, dosage, and route of administration in clinical application, aiming to discuss their mechanisms of repairing BBB integrity and potential for clinical application, and proposes future research directions. Stem cells and exosomes are expected to provide new strategies for early diagnosis and precise treatment of stroke, and promote breakthroughs in the field of stroke.
中风在全球范围内具有高发病率、高死亡率和高致残率的特点，其核心病理之一是血脑屏障（BBB）功能障碍。血脑屏障在保护脑组织和维持中枢神经系统（CNS）内环境稳态方面发挥着关键的生理作用。血脑屏障功能障碍是中风患者脑水肿、炎症及进一步神经损伤发展的关键因素。目前，干细胞及其衍生的外泌体在修复受损血脑屏障和改善中风后的神经功能方面已显示出显著潜力。干细胞通过抗炎、抗氧化、血管生成及调节细胞间信号机制来修复血脑屏障的完整性，而干细胞衍生的外泌体作为天然纳米载体，通过携带蛋白质、RNA和miRNA等活性物质进一步增强治疗效果。本文综述将介绍干细胞及其外泌体在中风治疗方面的最新研究进展，以及临床应用中细胞来源、移植时机、剂量和给药途径等方面的挑战，旨在探讨它们修复血脑屏障完整性的机制及临床应用潜力，并提出未来的研究方向。干细胞和外泌体有望为中风的早期诊断和精准治疗提供新策略，并推动中风领域的突破。
