Wu Kevin Y, Dave Archan, Nirwal Gurleen K, Giunta Michel, Nguyen Vincent D H, Tran Simon D
Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC, Canada.
Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
Adv Exp Med Biol. 2025;1488:103-131. doi: 10.1007/5584_2025_865.
Exosomes, a subset of extracellular vesicles, have emerged as potential therapeutic agents in ophthalmology due to their ability to modulate immune responses, facilitate cellular communication, and promote tissue repair. This chapter explores the potential applications of exosome-based therapies in corneal and anterior segment disorders, retinal diseases, glaucoma, and Sjögren's syndrome. In corneal disorders, mesenchymal stem cell (MSC)-derived secretomes have shown promise in accelerating wound healing, reducing fibrosis, and modulating inflammation, with hydrogel encapsulation strategies potentially enhancing their efficacy. In retinal diseases, exosomes may provide neuroprotective effects in age-related macular degeneration, diabetic retinopathy, and retinitis pigmentosa by modulating oxidative stress and inflammation. In glaucoma, secretome-based therapies could support retinal ganglion cell survival and optic nerve regeneration, though their impact on intraocular pressure via the trabecular meshwork remains uncertain. Additionally, exosomal biomarkers in aqueous humor are being investigated as potential diagnostic tools. In Sjögren's syndrome, exosomal biomarkers may facilitate earlier detection, while stem cell-derived exosomes hold promise in modulating immune responses and restoring glandular function. Despite encouraging preclinical and early clinical findings, standardization, scalability, and long-term safety must be addressed before clinical translation. Future research will focus on optimizing exosome-based therapies and exploring their feasibility for ophthalmic applications.
外泌体是细胞外囊泡的一个亚群，由于其具有调节免疫反应、促进细胞通讯和促进组织修复的能力，已成为眼科潜在的治疗药物。本章探讨了基于外泌体的疗法在角膜和眼前节疾病、视网膜疾病、青光眼和干燥综合征中的潜在应用。在角膜疾病中，间充质干细胞（MSC）衍生的分泌组在加速伤口愈合、减少纤维化和调节炎症方面显示出前景，水凝胶封装策略可能会提高其疗效。在视网膜疾病中，外泌体可通过调节氧化应激和炎症，在年龄相关性黄斑变性、糖尿病视网膜病变和色素性视网膜炎中发挥神经保护作用。在青光眼中，基于分泌组的疗法可支持视网膜神经节细胞存活和视神经再生，但其对小梁网眼压的影响仍不确定。此外，房水中的外泌体生物标志物正在作为潜在的诊断工具进行研究。在干燥综合征中，外泌体生物标志物可能有助于早期检测，而干细胞衍生的外泌体在调节免疫反应和恢复腺功能方面具有前景。尽管临床前和早期临床研究结果令人鼓舞，但在临床转化之前，必须解决标准化、可扩展性和长期安全性问题。未来的研究将集中于优化基于外泌体的疗法，并探索其在眼科应用中的可行性。
