中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (10): 4653-4663.doi: 10.4103/NRR.NRR-D-25-00133

• 综述:神经损伤修复保护与再生 • 上一篇    下一篇

外泌体：神经损伤修复新治疗新策略

  

  • 出版日期:2026-10-15 发布日期:2026-06-11
  • 基金资助:
    国家自然科学基金（82471414）和山东省自然科学基金（ZR2023MH365）

Extracellular vesicles: A new therapeutic drug for nerve injury repair.

Jinyi Cai1, Chongkang Ren2, Changshui Wang3, Songmin Shen1, Biao Xu1, Changmeng Cui3, *   

  1. 1 Jining Medical University, Jining, Shandong Province, China; 
    2 Department of Neurosurgery, The First Bethune Hospital of Jilin University, Changchun, Jilin Province, China; 
    3 Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong Province, China
  • Online:2026-10-15 Published:2026-06-11
  • Contact: Changmeng Cui, PhD, cmcuidr1989@163.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, No. 82471414; the Natural Science Foundation of Shandong Province, No. ZR2023MH365 (both to CC). 

PDF

3

摘要：

外泌体是由细胞主动释放的膜结构，能够高效介导细胞间通信，并在重塑微环境中发挥重要作用。外泌体携带的多种生物活性成分(包括miRNA、蛋白质和脂质)及其穿越血脑屏障的能力，在神经再生领域展现出广阔的治疗前景。目前的研究重点在于探索不同来源的外泌体(包括间充质干细胞、神经干细胞、神经元和血管细胞来源的外泌体)在神经修复中的作用机制及其临床转化潜力。限制临床转化的关键问题包括缺乏标准化的分离和表征方法、剂量确定和生物利用度评估不足，以及长期安全性的证据有限。文章总结了不同来源的外泌体在脑损伤、脊髓损伤和神经退行性疾病等神经系统疾病中的治疗研究进展，全面概述了涉及外泌体的关键分子调控网络，包括神经炎症调节、轴突再生、线粒体功能和代谢稳态，以及神经血管单元的结构和功能支持。此外，文章评估了外泌体作为药物递送载体的可行性。总之，外泌体构成一个多途径动态调节网络，深入阐明其作用机制有望促进神经修复领域新型治疗策略的发展，并为精准医学提供新的视角和解决方案。


https://orcid.org/0000-0001-9038-0673 (Changmeng Cui)

关键词: 脑疾病, 中枢神经系统疾病, 外泌体, 间充质干细胞, 小胶质细胞, 神经再生, 神经退行性疾病, 脊髓损伤

Abstract: Extracellular vesicles are membranous structures actively released by cells. They efficiently mediate intercellular communication and play a role in reshaping the microenvironment. Their diverse bioactive cargo, including miRNAs, proteins, and lipids, along with their ability to cross the blood–brain barrier, holds broad therapeutic promise in the field of neuroregeneration. Current research focuses on exploring the mechanisms of action and clinical translational potential of extracellular vesicles from different sources, including exosomes derived from mesenchymal stem cells, neural stem cells, neurons, and vascular cells, in neural repair. Key issues restricting clinical translation include the lack of standardized isolation and characterization methods, insufficient dose determination and bioavailability assessment, and inadequate evidence for long-term safety. This review systematically summarizes the therapeutic research progress of extracellular vesicles from various sources in neurological disorders such as brain injury, spinal cord injury, and neurodegenerative diseases. It provides a comprehensive overview of the key molecular regulatory networks involving extracellular vesicles, including the regulation of neuroinflammation, axonal regeneration, mitochondrial function and metabolic homeostasis, as well as structural and functional support of the neurovascular unit. In addition, this review assesses the feasibility of extracellular vesicles as drug delivery vehicles. In summary, extracellular vesicles constitute a dynamic and multi-pathway regulatory network. A thorough elucidation of their mechanisms of action is expected to facilitate the development of novel therapeutic strategies in the field of neural repair and provide new perspectives and solutions for precision medicine. 

Key words: brain diseases, central nervous system diseases, exosomes, extracellular vesicles, mesenchymal stem cells, microglia, nerve regeneration, neurodegenerative diseases, spinal cord injuries