2023, Vol. 27 ›› Issue (10): 1610-1617

Application and effect of extracellular vesicles in cardiac repair after myocardial infarction

Yue Feifei1, Song Yu1, Wang Xiaobei2, Wang Lin1, 2   

Abstract: BACKGROUND: As the research progresses, the increasing evidence has shown that mesenchymal stem cells mainly exert their therapeutic effects through paracrine mechanisms, and extracellular vesicles are an important paracrine component of cells. Therefore, extracellular vesicles have attracted considerable interest, especially in the cardiovascular field.
OBJECTIVE: To review the progress in the treatment of myocardial infarction with extracellular vesicles and explore the clinical application prospects of extracellular vesicles.
METHODS: The relevant articles were searched from CNKI and PubMed databases by computer. The search terms were “extracellular vesicles, myocardial infarction, cardiac repair” in Chinese and “extracellular vesicles, mesenchymal stem cell, embryonic stem cell, induced pluripotent stem cell, cardiomyocyte, target, myocardial infarction, cardiac repair” in English. The time was limited from 2016 to 2021. Finally, 70 articles were included for this review.
RESULTS AND CONCLUSION: (1) At present, many studies have successfully used extracellular vesicles to treat myocardial infarction and obtained considerable efficacy. Stem cells, such as mesenchymal stem cells, and some differentiated cell-derived extracellular vesicles can help the infarcted heart maintain normal physiological structure and function by inhibiting apoptosis of hypoxic cardiomyocytes, promoting angiogenesis in the infarct border zone, inhibiting the inflammation or reducing the fibrosis. (2) The mechanism of some cargoes carried by extracellular vesicles for the repair of myocardial infarction has been clarified, of which many microribonucleic acids play important roles in some pivotal cardiac repair signaling pathways, such as miR-21, miR-486-5p, and miR-144. Therefore, more studies are no longer limited to the application of naturally derived extracellular vesicles, but further load therapeutic drugs in extracellular vesicles or modify the membrane components of extracellular vesicles, thereby improving their myocardium targeting ability and cardiac repair potential.
Key words: microribonucleic acid, extracellular vesicle, myocardial infarction, cardiac repair, review