Novel Applications of Mesenchymal Stem Cell-Derived Exosomes for Myocardial Infarction Therapeutics

Abstract

Cardiovascular diseases (CVDs) are the leading cause of mortality and morbidity globally, representing approximately a third of all deaths every year. The greater part of these cases is represented by myocardial infarction (MI), or heart attack as it is better known, which occurs when declining blood flow to the heart causes injury to cardiac tissue. Mesenchymal stem cells (MSCs) are multipotent stem cells that represent a promising vector for cell therapies that aim to treat MI due to their potent regenerative effects. However, it remains unclear the extent to which MSC-based therapies are able to induce regeneration in the heart and even less clear the degree to which clinical outcomes could be improved. Exosomes, which are small extracellular vesicles (EVs) known to have implications in intracellular communication, derived from MSCs (MSC-Exos), have recently emerged as a novel cell-free vector that is capable of conferring cardio-protection and regeneration in target cardiac cells. In this review, we assess the current state of research of MSC-Exos in the context of MI. In particular, we place emphasis on the mechanisms of action by which MSC-Exos accomplish their therapeutic effects, along with commentary on the current difficulties faced with exosome research and the ongoing clinical applications of stem-cell derived exosomes in different medical contexts.

The role of small extracellular vesicles in cerebral and myocardial ischemia—Molecular signals, treatment targets, and future clinical translation

“…It has been shown that MSC‐EVs and EVs from other cell sources affect peripheral immunity in myocardial infarction, 99 an observation also made after ischemic stroke in mice 39,100 . MSC‐EVs affect several immune cell subsets, such as T and B lymphocytes.…”

Regenerative Potential of DPSCs and Revascularization: Direct, Paracrine or Autocrine Effect?

“…Paracrine signaling can also include exosomes or extracellular vescicles (EVs) that recently have emerged to be as novel cell-free vector in target tissue [80]. For example the use of exosomes and existing clinical material (collagen tape) for dental pulp tissue regeneration have been tested, in animal models, as a regenerative endodontic treatment [81].…”

Exosomes and Extracellular Vesicles in Myeloid Neoplasia: The Multiple and Complex Roles Played by These “Magic Bullets”

“…The therapeutic effects of exosomes, and EVs in general, have already been extensively demonstrated, both when considering their natural properties and cargo and when engineered with drug molecules [144]. In particular, clinical trials focusing on exosome-based treatments have been reported in different clinical fields, such as cardiology [145][146][147], neurology [148][149][150], oncology [151][152][153], and immunology [154]. Along with all the other aspects mentioned in this review, the use of exosomes as therapeutic tools in oncohematology has only been recently explored and reported.…”