Stem cell-derived extracellular vesicles for myocardial infarction: a meta-analysis of controlled animal studies

Abstract

Aims Stem cell-derived extracellular vesicles (EVs) have emerged as a promising therapy for myocardial infarction, but its effects remain incompletely understood. We aim to systematically review the efficacy of EVs on myocardial infarction in both small and large animals. Methods On April 5, 2018, we searched the PubMed, Embase and Web of Science databases using variations of “myocardial infarction” and “extracellular vesicle”. Controlled studies about the treatment effects of stem cell-derived EVs in myocardial infarction animal model were included. Meta-regression analysis was used to reveal the factors affecting the EVs treatments. Results Of 1210 studies retrieved, 24 were eligible for meta-analysis. EVs injection was associated with the improvements of left ventricular ejection fraction (12.65%), fractional shortening (7.54%) and the reduction of infarct size/area at risk (-15.55%). Meta-regression analysis did not reveal the association between treatment efficacy and type of stem cell, ligation-to-injection interval, route of delivery, dosage of delivery or follow-up period (all P values > 0.05). The median quality score of eligible studies was only 1, indicating potential risks of bias. Conclusion Stem cell-derived EVs improve cardiac function and reduce infarct size in myocardial infarction animals, but current pool-up study reveals no associations between common factors and treatment effects.

Pharmacotherapy to gene editing: potential therapeutic approaches for Hutchinson–Gilford progeria syndrome

“…It reduces apoptosis, enhances cell proliferation, attenuates inflammatory responses, and induces angiogenesis (Alibhai et al 2018;Yang et al 2019). Several microRNAs (miR-126, 210, 146a, 19a, 21, 22) and bioactive molecules have been identified for such an action of the EVs (Alibhai et al 2018;Yang et al 2019). Further, microRNA-containing EVs have demonstrated atheroprotective activity.…”

Platelet-derived vesicles: diagnostic and predictive value in cardiovascular diseases

“…Thus, the balance between pro-coagulant and anti-coagulant properties of the platelet-derived vesicles plays an important role in supporting of hemostasis [24,25] . Intriguingly, there is evidence that the platelet-derived vesicles are cargo for several molecules, including chromatin, hormones, proteins, which mediate cell-to-cell cooperation, immune reaction, inflammatory response, and reparation [18][19][20][21][22] . It has been found that the main fraction of miRNA is localized in the platelet-derived vesicles, which protect miRNA from degradation in the circulation.…”

“…The populations of the Figure 1. The proportions and functions of several types of extracellular vesicles in circulation [20][21][22][23] . APC: antigen presenting cells platelet-derived EVs may distinguish each other in not just their size and immune phenotype, but yet they can have a difference in a density (utilized as sucrose density gradient in ultracentrifugation), proteomic and lipidomic profiles [40] .…”

“…In fact, the EVs are able to mediate the exchange of appropriate information between various cells. Finally, the EVs were found witnesses and biomarkers of several diseases, such as CV, autoimmune, infective, metabolic, renal, rheumatic, neurological, ocular diseases and malignancy [20][21][22][23] .…”

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

“…4 | STEM CELL-DERIVED EVs IN MYOCARDIAL ISCHEMIAA meta-analysis indicated that stem-cell-derived EVs significantly reduce infarct size and improve cardiac function in an animal model of myocardial infarction 61. EVs from different MSC sources were found to protect cardiomyocytes from injury and boost angiogenesis [62][63][64].…”