Ye Hailian, He Qi, Qi Fang, Xu Guangchao, Qahar Mulan, Deng Chenliang, Wei Zairong
Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
The 2011 Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Front Immunol. 2025 Jul 17;16:1609288. doi: 10.3389/fimmu.2025.1609288. eCollection 2025.
Mesenchymal Stem Cells (MSCs) and their secreted extracellular vesicles (EVs), particularly exosomes (Exos), have garnered significant attention for their potential in tissue repair, fibrosis, and tumor therapy. However, the therapeutic efficacy of mesenchymal stem cell-derived exosomes (MSC-Exos) is notably influenced by the disease-specific microenvironment. This review examines the mechanisms of action of MSCs and MSC-Exos in various diseases and analyzes the impact of inflammatory preconditioning on the functions and paracrine signaling of MSCs. We propose a personalized MSC preconditioning strategy based on the characteristics of the disease microenvironment to enhance the precision and efficacy of MSC-Exos therapy. Additionally, we discuss the limitations of traditional preconditioning strategies and introduce novel approaches for MSC preconditioning by simulating the disease microenvironment, such as using tissue homogenates and EVs derived from diseased tissues. These methods more accurately reflect the spatiotemporal features of the disease microenvironment, thereby improving the therapeutic potential of MSC-Exos. Finally, we explore the application of engineered exosomes loaded with key miRNAs targeting disease treatment, offering new insights for precision medicine.
间充质干细胞（MSCs）及其分泌的细胞外囊泡（EVs），特别是外泌体（Exos），因其在组织修复、纤维化和肿瘤治疗方面的潜力而备受关注。然而，间充质干细胞来源的外泌体（MSC-Exos）的治疗效果受到疾病特异性微环境的显著影响。本综述探讨了MSCs和MSC-Exos在各种疾病中的作用机制，并分析了炎症预处理对MSCs功能和旁分泌信号的影响。我们基于疾病微环境的特征提出了一种个性化的MSC预处理策略，以提高MSC-Exos治疗的精准性和疗效。此外，我们讨论了传统预处理策略的局限性，并介绍了通过模拟疾病微环境对MSC进行预处理的新方法，如使用组织匀浆和疾病组织来源的EVs。这些方法更准确地反映了疾病微环境的时空特征，从而提高了MSC-Exos的治疗潜力。最后，我们探索了装载靶向疾病治疗的关键miRNAs的工程化外泌体的应用，为精准医学提供了新的见解。
