Extracellular Vesicles in Regeneration and Rehabilitation Recovery after Stroke

Gualerzi, Alice; Picciolini, Silvia; Rodà, Francesca; Bedoni, Marzia

doi:10.3390/biology10090843

Cited by 8 publications

(10 citation statements)

References 89 publications

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“…Indeed, cEVs include multiple subpopulations of EVs released by all body cells, including those released by neurons and glial cells ( 97 ). It was already demonstrated their major involvement in the reparative mechanisms occurring in the brain after a lesion ( 98 , 99 ), but the complex composition of cEVs, their heterogeneity, their nanoscale dimensions and the laborious isolation and characterization methods have currently limited their application in a clinical scenario. Nonetheless, Raman spectroscopy can represent a turning point in the use of cEVs in clinics, allowing to condense in a continuous variable, information coming from multiple molecular compounds.…”

Section: Discussionmentioning

confidence: 99%

Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson’s disease: the VIRTREAD-PD randomized controlled trial protocol

Lombardi,

Baccini,

Gualerzi

et al. 2024

Front. Neurol.

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BackgroundIntensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson’s Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients’ performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on gait performances of TT + AVR versus TT alone in II-III stage PD patients with gait disturbance. Secondary aims are to assess the effects on balance, gait parameters and other motor and non-motor symptoms, and patient’s satisfaction and adherence to the treatment. As an exploratory aim, the study attempts to identify biomarkers of neuroplasticity detecting changes in Neurofilament Light Chain concentration T0-T1 and to identify prognostic biomarkers associated to blood-derived Extracellular Vesicles.MethodsSingle-center, randomized controlled single-blind trial comparing TT + AVR vs. TT in II-III stage PD patients with gait disturbances. Assessment will be performed at baseline (T0), end of training (T1), 3 (T2) and 6 months (T3, phone interview) from T1. The primary outcome is difference in gait performance assessed with the Tinetti Performance-Oriented Mobility Assessment gait scale at T1. Secondary outcomes are differences in gait performance at T2, in balance and spatial–temporal gait parameters at T1 and T2, patients’ satisfaction and adherence. Changes in falls, functional mobility, functional autonomy, cognition, mood, and quality of life will be also assessed at different timepoints. The G*Power software was used to estimate a sample size of 20 subjects per group (power 0.95, α < 0.05), raised to 24 per group to compensate for potential drop-outs. Both interventions will be customized and progressive, based on the participant’s performance, according to a predefined protocol.ConclusionThis study will provide data on the possible superiority of AVR-associated TT over conventional TT in improving gait and other motor and non-motor symptoms in persons with PD and gait disturbances. Results of the exploratory analysis could add information in the field of biomarker research in PD rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson’s disease: the VIRTREAD-PD randomized controlled trial protocol

Lombardi,

Baccini,

Gualerzi

et al. 2024

Front. Neurol.

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“…Recent studies have shown that EVs play an important role in the pathophysiological process of IS [ 87 , 88 ]. Researchers have found that many different cell-derived EVs have neuroprotective and nerve repair functions.…”

Section: Extracellular Vesiclesmentioning

confidence: 99%

Revolutionizing Ischemic Stroke Diagnosis and Treatment: The Promising Role of Neurovascular Unit-Derived Extracellular Vesicles

Gao,

Liu,

Yue

et al. 2024

Biomolecules

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Ischemic stroke is a fatal and disabling disease worldwide and imposes a significant burden on society. At present, biological markers that can be conveniently measured in body fluids are lacking for the diagnosis of ischemic stroke, and there are no effective treatment methods to improve neurological function after ischemic stroke. Therefore, new ways of diagnosing and treating ischemic stroke are urgently needed. The neurovascular unit, composed of neurons, astrocytes, microglia, and other components, plays a crucial role in the onset and progression of ischemic stroke. Extracellular vesicles are nanoscale lipid bilayer vesicles secreted by various cells. The key role of extracellular vesicles, which can be released by cells in the neurovascular unit and serve as significant facilitators of cellular communication, in ischemic stroke has been extensively documented in recent literature. Here, we highlight the role of neurovascular unit-derived extracellular vesicles in the diagnosis and treatment of ischemic stroke, the current status of extracellular vesicle engineering for ischemic stroke treatment, and the problems encountered in the clinical translation of extracellular vesicle therapies. Extracellular vesicles derived from the neurovascular unit could provide an important contribution to diagnostic and therapeutic tools in the future, and more studies in this area should be carried out.

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“…Altering inflammatory responses ( Grieco et al, 2021 ), tissue/wound healing ( Bray et al, 2021 ; Costa et al, 2022 ), and brain remodeling ( Gualerzi et al, 2021 ) are all active areas of research with EV products for both tracking and inducing regenerative processes ( Gualerzi et al, 2021 ). Inhibiting inflammation is an avid area of EV research.…”

Section: Evs As Personalized Therapiesmentioning

confidence: 99%