Xu Haiyan, Yang Lanlan, Wang Weitie, Zhang Chengwei
Department of Rehabilitation Therapeutics, School of Nursing, Jilin University, Changchun, Jilin, China.
Department of Biliary and Pancreatic Internal Medicine, The Second Hospital of Jilin University, Changchun, Jilin, China.
Front Genet. 2025 Aug 29;16:1639756. doi: 10.3389/fgene.2025.1639756. eCollection 2025.
Stroke poses a serious threat to human health and life, serving as a leading cause of death and disability in adults. The incidence rate of stroke continues to rise annually. Following the onset of ischemic stroke, most patients experience a period of spontaneous recovery. Neural repair after cerebral ischemia is closely associated with neurovascular plasticity, which facilitates the regeneration and repair of nerves and blood vessels in the ischemic injury area. Mesenchymal stem cells (MSCs), adult stem cells isolated from bone marrow or other tissues, can differentiate into various cell types and possess characteristics such as self-renewal, low immunogenicity, and easy of isolation. Exosomes are regarded as the primary mediators of MSC functions. These specialized extracellular vesicles play critical roles in intercellular communication, targeted transport, and regulation of recipient cell functions through their surface molecules and cargo (e.g., proteins, RNA, and other bioactive factors). Studies demonstrate that MSCs and their exosomes participate in both neuronal and vascular endothelial cell damage and repair after stroke. They exert distinct effects at different stages of cerebral ischemia injury, promoting angiogenesis, neurogenesis, and reducing inflammation. While preclinical studies show promising therapeutic potential, clinical translation faces challenges such as standardization of exosome isolation, optimal dosing, delivery methods, and long-term safety evaluation. Future research should focus on overcoming these barriers to facilitate their application in stroke therapy. This review summarizes current research on the therapeutic potential of MSCs and their exosomes in ischemic brain injury.
中风对人类健康和生命构成严重威胁，是成年人死亡和残疾的主要原因。中风的发病率每年持续上升。缺血性中风发作后，大多数患者会经历一段自发恢复的时期。脑缺血后的神经修复与神经血管可塑性密切相关，神经血管可塑性有助于缺血损伤区域神经和血管的再生与修复。间充质干细胞（MSCs）是从骨髓或其他组织中分离出来的成体干细胞，能够分化为多种细胞类型，并具有自我更新、低免疫原性和易于分离等特性。外泌体被认为是MSCs功能的主要介导者。这些特殊的细胞外囊泡通过其表面分子和货物（如蛋白质、RNA和其他生物活性因子）在细胞间通讯、靶向运输和受体细胞功能调节中发挥关键作用。研究表明，MSCs及其外泌体参与中风后神经元和血管内皮细胞的损伤与修复。它们在脑缺血损伤的不同阶段发挥不同作用，促进血管生成、神经发生并减轻炎症。虽然临床前研究显示出有前景的治疗潜力，但临床转化面临着外泌体分离标准化、最佳剂量、给药方法和长期安全性评估等挑战。未来的研究应专注于克服这些障碍，以促进它们在中风治疗中的应用。本综述总结了目前关于MSCs及其外泌体在缺血性脑损伤治疗潜力的研究。
