Effectiveness of mesenchymal stem cell-derived extracellular vesicles therapy for Parkinson's disease: A systematic review of preclinical studies.

BACKGROUND

Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) can traverse the blood-brain barrier due to their small size. This characteristic makes them a research hotspot for the treatment of Parkinson's disease (PD) and is expected to be a potentially revolutionary strategy for treating PD. Despite this, no summary of clinical trial results has been reported.

AIM

To assess the efficacy and durability of MSC-EVs in treating PD.

METHODS

Systematic searches were conducted in four electronic databases until June 2024 to collect studies on the use of MSC-EVs for this purpose. Thirteen relevant randomized controlled trials, encompassing 16 experiments, were selected for inclusion.

RESULTS

Behavioral assessments, including the rotarod and apomorphine turning behavior tests, indicated improvements in motor coordination ( < 0.00001); the Pole test and the Wire-hang test showed enhanced limb motor agility and synchronization ( = 0.003 and < 0.00001, respectively). Histopathologically, there was a reduction in inflammatory markers such as tumor necrosis factor-α and interleukin-6 ( = 0.03 and = 0.01, respectively) and an increase in tyrosine hydroxylase-positive cells in the lesion areas ( < 0.00001).

CONCLUSION

MSC-EV therapy for PD is a gradual process, with significant improvements observable more than 2 weeks after administration and lasting at least 8 weeks. This study is the first to demonstrate the efficacy and durability of MSC-EV treatment in PD.