PDF(Pubmed)
Abstract：
Gap injuries to the peripheral nervous system result in pain and loss of function, without any particularly effective therapeutic options. Within this context, mesenchymal stem cell (MSC)-derived exosomes have emerged as a potential therapeutic option. Thus, the focus of this study was to review currently available data on MSC-derived exosome-mounted scaffolds in peripheral nerve regeneration in order to identify the most promising scaffolds and exosome sources currently in the field of peripheral nerve regeneration. We conducted a systematic review following PRISMA 2020 guidelines. Exosome origins varied (adipose-derived MSCs, bone marrow MSCs, gingival MSC, induced pluripotent stem cells and a purified exosome product) similarly to the materials (Matrigel, alginate and silicone, acellular nerve graft [ANG], chitosan, chitin, hydrogel and fibrin glue). The compound muscle action potential (CMAP), sciatic functional index (SFI), gastrocnemius wet weight and histological analyses were used as main outcome measures. Overall, exosome-mounted scaffolds showed better regeneration than scaffolds alone. Functionally, both exosome-enriched chitin and ANG showed a significant improvement over time in the sciatica functional index, CMAP and wet weight. The best histological outcomes were found in the exosome-enriched ANG scaffold with a high increase in the axonal diameter and muscle cross-section area. Further studies are needed to confirm the efficacy of exosome-mounted scaffolds in peripheral nerve regeneration.
摘要：
周围神经系统的间隙损伤导致疼痛和功能丧失，没有任何特别有效的治疗选择。在此背景下,间充质干细胞（MSC）来源的外泌体已成为潜在的治疗选择。因此，这项研究的重点是回顾目前可用的有关MSC衍生的外泌体支架在周围神经再生中的数据,以确定目前在周围神经再生领域中最有希望的支架和外泌体来源.我们遵循PRISMA2020指南进行了系统审查。外泌体起源各不相同(脂肪来源的MSCs，骨髓间充质干细胞，牙龈MSC，诱导多能干细胞和纯化的外泌体产品)类似于材料(Matrigel，海藻酸盐和有机硅，脱细胞神经移植物[ANG]，壳聚糖,甲壳素,水凝胶和纤维蛋白胶)。复合肌肉动作电位（CMAP），坐骨神经功能指数(SFI)，腓肠肌湿重和组织学分析被用作主要结局指标.总的来说,外泌体支架显示比单独的支架更好的再生。功能上,富含外泌体的甲壳素和ANG都显示出坐骨神经痛功能指数随时间的显着改善，CMAP和湿重。在富含外泌体的ANG支架中发现了最佳的组织学结果，轴突直径和肌肉横截面积大大增加。需要进一步的研究来证实外泌体安装支架在周围神经再生中的功效。
