中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (5): 1221-1235.doi: 10.4103/NRR.NRR-D-23-02051

• 综述:神经损伤修复保护与再生 •    下一篇

外泌体：缺血性脑卒中的新一代治疗平台

  

  • 出版日期:2025-05-15 发布日期:2024-10-29

Exosomes: the next-generatton therapeuttc plattorm for ischemic stroke

Wenjing Yin1 , Hongyin Ma1 , Yang Qu1 , Jiaxin Ren1 , Yingying Sun1 , Zhen-Ni Guo1, 2, * , Yi Yang1, *   

  1. 1 Stroke Center, Department of Neurology, First Hospital of Jilin University, Changchun, Jilin Province, China; 2 Neuroscience Research Center, Department of Neurology, First Hospital of Jilin University, Changchun, Jilin Province, China
  • Online:2025-05-15 Published:2024-10-29
  • Contact: Zhen-Ni Guo, MD, PhD, zhen1ni2@jlu.edu.cn; Yi Yang, MD, PhD, yang_yi@jlu.edu.cn.
  • Supported by:
    This work was supported by the Nattonal Natural Science Foundatton of China, Nos. 82071291 (to YY), 82301464 (to HM); the Norman Bethune Health Science Center of Jilin University, No. 2022JBGS03 (to YY); a grant from Department of Science and Technology of Jilin Province, Nos. YDZJ202302CXJD061 (to YY), 20220303002SF (to YY); a grant from Jilin Provincial Key Laboratory, No. YDZJ202302CXJD017 (to YY); Talent Reserve Program of First Hospital of Jilin University, No. JDYYCB-2023002 (to ZNG).

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摘要：

目前的缺血性脑卒中治疗策略并不能达到恢复神经功能的目的。因此，迫切需要开发治疗缺血性脑卒中的新方法。外泌体是源自细胞的天然囊泡，在生理和病理条件下介导细胞间的信号转导，它具有免疫原性低、稳定性好、递送效率高和能穿过血脑屏障等特点，外泌体的这些生理特性有望为缺血性脑卒中治疗带来新的突破。此外，纳米技术的飞速发展推动了工程外泌体的革新，可有效提高靶向能力、增强疗效并最大限度地减少剂量，这些技术的进步也促进了外泌体的临床转化。为此，文章介绍了外泌体自身的治疗作用及其在当前缺血性脑卒中治疗策略中的积极作用，主要包括抗炎、抗凋亡、自噬调节、血管生成、神经再生和减少胶质瘢痕形成等。然而，值得注意的是，虽然外泌体显示出巨大的治疗功效，但目前还缺乏表征标准和高纯度外泌体的有效分离。未来的优化策略应倾向于探索合适的分离技术并建立统一的工作流程，以有效地将外泌体应用于缺血性脑卒中的诊断或治疗。该综述为开发基于外泌体的缺血性脑卒中疗法提供了新思路。

https://orcid.org/0000-0002-8922-3862 (Zhen-Ni Guo); https://orcid.org/0000-0002-9729-8522 (Yi Yang)

关键词: 血脑屏障, 电针, 工程, 运动, 外泌体, 缺血性中风, 间充质干细胞, 小胶质细胞, 神经保护, 支架

Abstract: Current therapeutic strategies for ischemic stroke fall short of the desired objective of neurological functional recovery. Therefore, there is an urgent need to develop new methods for the treatment of this condition. Exosomes are natural cell-derived vesicles that mediate signal transduction between cells under physiological and pathological conditions. They have low immunogenicity, good stability, high delivery efficiency, and the ability to cross the blood–brain barrier. These physiological properties of exosomes have the potential to lead to new breakthroughs in the treatment of ischemic stroke. The rapid development of nanotechnology has advanced the application of engineered exosomes, which can effectively improve targeting ability, enhance therapeutic efficacy, and minimize the dosages needed. Advances in technology have also driven clinical translational research on exosomes. In this review, we describe the therapeutic effects of exosomes and their positive roles in current treatment strategies for ischemic stroke, including their anti-inflammation, anti-apoptosis, autophagy-regulation, angiogenesis, neurogenesis, and glial scar formation reduction effects. However, it is worth noting that, despite their significant therapeutic potential, there remains a dearth of standardized characterization methods and efficient isolation techniques capable of producing highly purified exosomes. Future optimization strategies should prioritize the exploration of suitable isolation techniques and the establishment of unified workflows to effectively harness exosomes for diagnostic or therapeutic applications in ischemic stroke. Ultimately, our review aims to summarize our understanding of exosome-based treatment prospects in ischemic stroke and foster innovative ideas for the development of exosome-based therapies.

Key words: blood-brain barrier, electroacupuncture, engineering, exercise, exosomes, ischemic stroke, mesenchymal stem cells, microglia, neuroprotection, stents