Exosomes have shown good potential for alleviating neurological
deficits and delaying memory deterioration, but the neuroprotective
effects of exosomes remain unknown. Methylmalonic acidemia is a metabolic
disorder characterized by the accumulation of methylmalonic acid (MMA)
in various tissues that inhibits neuronal survival and function, leading
to accelerated neurological deterioration. Effective therapies to
mitigate these symptoms are lacking. The purpose of this study was
to explore the neuroprotective effects of plasma exosomes on cells
and a mouse model of MMA-induced injury. We evaluated the ability
of plasma exosomes to reduce the neuronal apoptosis, cross the blood–brain
barrier, and affect various parameters related to neuronal function.
MMA promoted cell apoptosis, disrupted the metabolic balance, and
altered the expression of B-cell lymphoma-2 (Bcl-2), Bcl2-associated
X (Bax), and synaptophysin-1 (Syp-1), and these changes may be involved
in MMA-induced neuronal apoptosis. Additionally, plasma exosomes normalized
learning and memory and protected against MMA-induced neuronal apoptosis.
Our findings indicate that neurological deficits are linked to the
pathogenesis of methylmalonic acidemia, and healthy plasma exosomes
may exert neuroprotective and therapeutic effects by altering the
expression of exosomal microRNAs, facilitating neuronal functional
recovery in the context of this inherited metabolic disease. Intravenous
plasma-derived exosome treatment may be a novel clinical therapeutic
strategy for methylmalonic acidemia.