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外泌体在疾病诊断和治疗策略临床应用中的最新进展。

Recent advances in the clinical application of exosomes for disease diagnosis and therapeutic strategies.

作者信息

Wen Caining, Ma Hui, Xu Limei, Gu Zhaodi, Li Hao, Zhang Yuanmin, Liang Yujie, Xu Xiao

机构信息

Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China.

College of Rehabilitation Medicine, Jining Medical University, Jining, China.

出版信息

Int J Surg. 2025 Jul 1;111(7):4609-4628. doi: 10.1097/JS9.0000000000002518. Epub 2025 May 16.

Abstract

As pivotal mediators of intercellular communication, exosomes play a crucial role in transferring cellular cargo and regulating various biological functions. These extracellular vesicles encapsulate a diverse array of biomolecules, including nucleic acids, proteins, and lipids, which can serve as biomarkers for precise monitoring of physiological and pathological processes. Remarkably, exosomes derived from stem cells are densely packed with bioactive molecules that enable precise and selective intercellular communication, effectively dampen inflammatory responses, and actively drive tissue repair and regeneration. These attributes underscore their immense potential as a next-generation, cell-free therapeutic modality. Beyond their therapeutic potential, exosomes, characterized by their nanoscale size and excellent biocompatibility, serve as natural delivery vehicles for small molecules, proteins, and nucleic acids, making them highly suitable for targeted drug delivery and precision medicine applications. In this review, we provide a comprehensive analysis of the latest advancements in the clinical applications of exosomes, encompassing both diagnostic and therapeutic perspectives. Additionally, we critically assess the current limitations hindering their clinical translation and explore the potential of engineered exosomes in treating a wide range of diseases.

摘要

作为细胞间通讯的关键介质,外泌体在传递细胞货物和调节各种生物学功能方面发挥着至关重要的作用。这些细胞外囊泡包裹着各种各样的生物分子,包括核酸、蛋白质和脂质,它们可作为生物标志物,用于精确监测生理和病理过程。值得注意的是,源自干细胞的外泌体富含生物活性分子,能够实现精确且选择性的细胞间通讯,有效减轻炎症反应,并积极推动组织修复和再生。这些特性突显了它们作为下一代无细胞治疗方式的巨大潜力。除了其治疗潜力外,外泌体具有纳米级尺寸和出色的生物相容性,可作为小分子、蛋白质和核酸的天然递送载体,使其非常适合靶向药物递送和精准医学应用。在本综述中,我们对外泌体临床应用的最新进展进行了全面分析,涵盖诊断和治疗两个视角。此外,我们批判性地评估了阻碍其临床转化的当前局限性,并探讨了工程化外泌体在治疗多种疾病方面的潜力。

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