中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (1): 6-22.doi: 10.4103/NRR.NRR-D-24-00665

• 综述:脑损伤修复保护与再生 •    下一篇

外泌体在脑卒中治疗中的应用:脑卒中治疗范式有望发生转变

  

  • 出版日期:2026-01-15 发布日期:2025-04-18
  • 基金资助:
    本研究由重庆市自然科学基金资助,编号:CSTB2023NSCQ-mSX0561(WYL)

Exosomes in stroke management: A promising paradigm shift in stroke therapy

Bo Wang1, #, Pinzhen Chen2, #, Wenyan Li1, *, Zhi Chen1, *   

  1. 1 Department of Neurosurgery, The First Hospital Affiliated to Army Medical University, Chongqing, China;  2 Department of Radiology, The First Hospital Affiliated to Army Medical University, Chongqing, China
  • Online:2026-01-15 Published:2025-04-18
  • Contact: Zhi Chen, MD, zhichen@tmmu.edu.cn; Wenyan Li, MD, lwy243@tmmu.edu.cn.
  • Supported by:
    This work was supported by the Natural Science Foundation of Chongqing, No. CSTB2023NSCQ-mSX0561 (to WL).

摘要:

脑卒中是一种常见的高死亡率的脑血管疾病,有效的治疗方法尚有待提出。作为一种无细胞疗法,外泌体疗法可在动物模型中对各种疾病产生良好疗效。然而,目前还没有足够的证据来指导外泌体在脑卒中患者中的临床应用效果。为此,文章综述了外泌体在脑卒中治疗中的应用进展,以期阐明外泌体在脑卒中治疗中的巨大潜在价值,并为其临床转化提供参考。文章结果发现,许多与脑卒中相关的外泌体研究正在积极进行中。在临床前研究方面,外泌体作为一种生物活性物质,目前主要以干细胞为主要来源。由于外泌体具有高度可塑性,可以通过各种物理、化学和基因工程方法对其进行有效改造,以提高其效率。在脑卒中动物模型中,外泌体的干预可以减少神经炎症反应、减轻氧化应激损伤和程序性细胞死亡。此外,外泌体还能促进血管生成,修复和再生受损的白质纤维束,促进神经干细胞的迁移和分化,从而促进脑卒中后的修复过程。通过脑室-脑膜淋巴系统对外泌体进行干预正在成为外泌体应用的新方向,这说明脑卒中治疗范式有望发生转变。

https://orcid.org/0000-0002-8404-4937 (Zhi Chen); https://orcid.org/0000-0003-1861-6383 (Wenyan Li)

关键词: 血管生成, 动物模型, 脑血管疾病, 细胞外囊泡, 死亡率, 神经干细胞, 神经炎症, 氧化应激, 程序性细胞死亡, 治疗

Abstract: Effective treatment methods for stroke, a common cerebrovascular disease with a high mortality rate, are still being sought. Exosome therapy, a form of acellular therapy, has demonstrated promising efficacy in various diseases in animal models; however, there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke. This article reviews the progress of exosome applications in stroke treatment. It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation. At present, many studies on exosome-based therapies for stroke are actively underway. Regarding preclinical research, exosomes, as bioactive substances with diverse sources, currently favor stem cells as their origin. Due to their high plasticity, exosomes can be effectively modified through various physical, chemical, and genetic engineering methods to enhance their efficacy. In animal models of stroke, exosome therapy can reduce neuroinflammatory responses, alleviate oxidative stress damage, and inhibit programmed cell death. Additionally, exosomes can promote angiogenesis, repair and regenerate damaged white matter fiber bundles, and facilitate the migration and differentiation of neural stem cells, aiding the repair process. We also summarize new directions for the application of exosomes, specifically the exosome intervention through the ventricular–meningeal lymphatic system. The review findings suggest that the treatment paradigm for stroke is poised for transformation.

Key words: angiogenesis, animal model, cerebrovascular disorder, extracellular vesicle, mortality rates, neural stem cell, neuroinflammation, oxidative stress, programmed cell death, therapy