Exosome-mediated repair of spinal cord injury: a promising therapeutic strategy

Abstract

Spinal cord injury (SCI) is a catastrophic injury to the central nervous system (CNS) that can lead to sensory and motor dysfunction, which seriously affects patients' quality of life and imposes a major economic burden on society. The pathological process of SCI is divided into primary and secondary injury, and secondary injury is a cascade of amplified responses triggered by the primary injury. Due to the complexity of the pathological mechanisms of SCI, there is no clear and effective treatment strategy in clinical practice. Exosomes, which are extracellular vesicles of endoplasmic origin with a diameter of 30–150 nm, play a critical role in intercellular communication and have become an ideal vehicle for drug delivery. A growing body of evidence suggests that exosomes have great potential for repairing SCI. In this review, we introduce exosome preparation, functions, and administration routes. In addition, we summarize the effect and mechanism by which various exosomes repair SCI and review the efficacy of exosomes in combination with other strategies to repair SCI. Finally, the challenges and prospects of the use of exosomes to repair SCI are described.

Spinal Cord Injury Management Based on Microglia-Targeting Therapies

“…Studies have shown that neural stem cell-derived MVs (NSC-MVs) can reduce microglial activation, alleviate SCI-related impairments, and encourage locomotor recovery by inducing autophagy [82]. MSC-derived MVs also exhibit regula-tory effects on microglial activation, lowering proinflammatory cytokine secretion and promoting the expression of anti-inflammatory markers [83]. Additionally, MSC-derived exosomes exert anti-inflammatory effects on microglia by interfering with TLR4 signaling and modulating the expression of microRNAs targeting microglia [84].…”