Clinical Theragnostic Signature of Extracellular Vesicles in Traumatic Brain Injury (TBI)

Abstract

Traumatic brain injury (TBI) is a common cause of disability and fatality worldwide. Depending on the clinical presentation, it is a type of acquired brain damage that can be mild, moderate, or severe. The degree of patient's discomfort, prognosis, therapeutic approach, survival rates, and recurrence can all be strongly impacted by an accurate diagnosis made early on. The Glasgow Coma Scale (GCS), along with neuroimaging (MRI (Magnetic Resonance Imaging) and CT scan), is a neurological assessment tools used to evaluate and categorize the severity of TBI based on the patient's level of consciousness, eye opening, and motor response. Extracellular vesicles (EVs) are a growing domain, explaining neurological complications in a more detailed manner. EVs, in general, play a role in cellular communication. Its molecular signature such as DNA, RNA, protein, etc. contributes to the status (health or pathological stage) of the parental cell. Brain-derived EVs support more specific screening (diagnostic and prognostic) in TBI research. Therapeutic impact of EVs are more promising for aiding in TBI healing. It is nontoxic, biocompatible, and capable of crossing the blood−brain barrier (BBB) to transport therapeutic molecules. This review has highlighted the relationships between EVs and TBI theranostics, EVs and TBI-related clinical trials, and related research domain-associated challenges and solutions. This review motivates further exploration of associations between EVs and TBI and develops a better approach to TBI management.

Extracellular vesicles as nanotheranostic platforms for targeted neurological disorder interventions

“…Notably, the exosomes from these cells are rich in miRNAs and proteins that support neuroregeneration, inhibit apoptosis and inflammation, provide antioxidant benefits, and repair the BBB [ 114 ]. Furthermore, these exosomes harbor miRNAs and proteins critical for synaptic plasticity and cognitive function enhancement [ 202 ], marking them as a potent strategy for cell-free regenerative medicine in CNS disorders.…”

“…EVs present a natural and versatile option for this purpose. Because of the endogeneity of EVs, EV-based theranostics possess inherent biocompatibility and minimal immunogenicity compared to synthetic nanomaterials [202][203][204][205]. Their ability to cross the BBB and deliver a wide range of cargo, including proteins, lipids, nucleic acids, and drugs, makes them ideal for targeting CNS pathologies.…”

Extracellular Vesicles in the Central Nervous System: A Novel Mechanism of Neuronal Cell Communication

“…EVs, which are subdivided into three subtypes: microvesicles, exosomes, and apoptotic bodies, are a major constituent 2 of 23 of the cell secretome. EVs have the ability to circulate in the extracellular body fluid and modulate several biological processes and their associated pathways [4][5][6].…”