2023, Vol. 27 ›› Issue (19): 3061-3069

Adipose-derived mesenchymal stem cell exosomes for treating traumatic central nervous system injury

Liu Chuang1, Tan Longwang2, Zhou Heshan1, Zhang Chi1   

Abstract: BACKGROUND: Adipose-derived mesenchymal stem cell exosomes have the characteristics of strong damage repair function, high safety, passing blood-brain barrier, convenient material acquisition, and easy mass production, which makes it has the great potential in the treatment of traumatic central nervous system injuries.  
OBJECTIVE: To review the experimental research on the application of adipose-derived mesenchymal stem cell exosomes in the treatment of traumatic central nervous system injury in recent years, its research achievements and limitations, prospect the future development, and provide personal suggestions.
METHODS: CNKI, WanFang, PubMed, and Web of Science databases were searched for relevant articles using “adipose, mesenchymal stem cells, exosomes, traumatic central nervous system injury, spinal cord injury, traumatic brain injury, pathology” as the search terms in Chinese and English. Totally 42 articles that met the criteria were included for review.  
RESULTS AND CONCLUSION: (1) By summarizing relevant literature conclusions, adipose-derived mesenchymal stem cell exosomes are used to treat traumatic central nervous system injury through the following mechanisms: inhibiting inflammation in the injured area through nuclear factor-kB, MAPK and other pathways, inhibiting neuronal apoptosis through JNK3/c-jun, SRSF2-PKCδII-Bcl2 pathways, and promoting nerve regeneration through cAMP-response element binding protein, neurofilament protein, growth-associated protein 43, glial fibrillary acidic protein, and myelin basic protein pathways. (2) Existing problems: the above research results are from preclinical experiments. The neuroprotective effect of miR-133b overexpressed in adipose mesenchymal stem cells in this paper is inconsistent with the conclusions of other studies, and needs further verification. Adipose-derived mesenchymal stem cell exosomes may have the risk of obesity and cerebral hemorrhage in the field of traumatic central nervous system injury, and their safety needs further study. The biological components and therapeutic mechanisms of adipose derived mesenchymal stem cell exosomes are not well explored. At present, there is no unified consensus on the standardized preparation, storage, transportation and administration strategies (including time, route and dose) of adipose mesenchymal stem cell exosomes. (3) In conclusion, adipose derived stem cell exosomes have a great application potential in traumatic central nervous system injury. Preclinical research in this field should be strengthened and gradually transferred to clinical research, so as to provide a new treatment for traumatic central nervous system injury.

Key words: traumatic central nervous system injury, adipose, mesenchymal stem cell, exosome, spinal cord injury, traumatic brain injury, microglia, long noncoding RNA, microRNA