Kumar Ram Mohan Ram, Rajan Logesh, Chidambaram Saravana Babu
Department of Pharmaceutical Biotechnology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India.
Department of Pharmacognosy, M.S. Ramaiah University of Applied Sciences, Gnanagangothri Campus, Bengaluru, Karnataka, 56054, India.
Pharmaceut Med. 2025 Sep 19. doi: 10.1007/s40290-025-00584-9.
Exosomes, small extracellular vesicles (sEVs) that range in Size from 30 to 150 nm in diameter, have emerged as crucial mediators of intercellular communication within the central nervous system (CNS). They play significant roles in the pathogenesis and progression of various neurological and psychiatric disorders, including Alzheimer's disease, Parkinson's disease, ischemic stroke, depression, bipolar disorder, and autism spectrum disorder. Exosomes carry a diverse cargo of proteins, nucleic acids, lipids, and other bioactive molecules that can influence neuronal function and synaptic plasticity. In disease states, exosomes derived from stressed neurons or glial cells can propagate neuroinflammation, synaptic dysfunction, and cognitive decline. They may also mediate the spread of abnormal proteins or microRNAs, disrupting neuronal connectivity and neurotransmitter signaling and contributing to the development of proteinopathies and neurotoxicity. Owing to their presence in bodily fluids such as blood plasma, cerebrospinal fluid, and saliva, exosomes hold promise as biomarkers for these disorders. Moreover, their regulatory roles present new opportunities for developing novel diagnostic biomarkers and therapeutic interventions. This review provides an overview of the multifaceted roles of exosomes in neurological and psychiatric disorders. We delve into their contributions to disease pathogenesis, their potential as diagnostic biomarkers, and the innovative therapeutic strategies leveraging exosome-based delivery systems. By exploring the current state of research, we aim to highlight the translational potential of exosomes in revolutionizing the diagnosis and treatment of these disorders.
外泌体是直径在30到150纳米之间的小型细胞外囊泡（sEVs），已成为中枢神经系统（CNS）细胞间通讯的关键介质。它们在包括阿尔茨海默病、帕金森病、缺血性中风、抑郁症、双相情感障碍和自闭症谱系障碍在内的各种神经和精神疾病的发病机制和进展中发挥着重要作用。外泌体携带多种蛋白质、核酸、脂质和其他生物活性分子，这些分子可以影响神经元功能和突触可塑性。在疾病状态下，来自应激神经元或胶质细胞的外泌体可以传播神经炎症、突触功能障碍和认知衰退。它们还可能介导异常蛋白质或微小RNA的传播，破坏神经元连接和神经递质信号，促进蛋白病和神经毒性的发展。由于它们存在于血浆、脑脊液和唾液等体液中，外泌体有望成为这些疾病的生物标志物。此外，它们的调节作用为开发新型诊断生物标志物和治疗干预措施提供了新的机会。本综述概述了外泌体在神经和精神疾病中的多方面作用。我们深入探讨了它们对疾病发病机制的贡献、作为诊断生物标志物的潜力以及利用基于外泌体的递送系统的创新治疗策略。通过探索当前的研究现状，我们旨在突出外泌体在彻底改变这些疾病的诊断和治疗方面的转化潜力。
