Exosome

外泌体
  • 文章类型: Journal Article
    原理:心肌梗塞(MI)是一种严重的全球性临床疾病,普遍存在。成年哺乳动物心脏对损伤的反应产生新的心肌细胞(CMs)的能力有限仍然是开发有效疗法的主要障碍。目前的方法集中在通过细胞周期再入诱导现有CM的增殖。然而,这种方法主要提高细胞周期蛋白依赖性激酶6(CDK6)和DNA含量,缺乏适当的胞质分裂,并导致功能失调的双核CMs的形成。胞质分裂依赖于核糖体生物发生(Ribo-bio),核仁素(Ncl)调节的一个关键过程。我们的目标是确定一种促进DNA合成和胞质分裂的新方法。方法:各种技术,包括RNA/蛋白质测序分析,Ribo-Halo,Ribo-disome,流式细胞术,和心脏特异性肿瘤抑制视网膜母细胞瘤-1(Rb1)基因敲除小鼠,用于评估增殖/细胞周期再入和Ribo-bio/胞质分裂的系列信号传导。超声心动图,共焦成像,和组织学用于评估心功能。结果:与对照小鼠相比,分析显示MI小鼠心脏中Rb1的水平显着升高,circASXL1的水平降低。Rb1的缺失仅诱导细胞周期重新进入,同时增强Ribo-生物调节剂Ncl导致胞质分裂。机械上,生物信息学和损失/增益研究发现circASXL1/CDK6/Rb1调节细胞周期重新进入。此外,Ribo-Halo,Ribo-disome和circRNA下拉测定表明circASXL1通过Ncl/Ribo-bio促进胞质分裂。重要的是,来自脐带间充质干细胞(UMSC-Exo)的外泌体能够通过促进细胞周期折返和Ribo-bio/胞质分裂的协调信号来增强心脏功能。通过在UMSC-Exo中沉默circASXL1来减弱这些作用。结论:circASXL1/CDK6/Rb1/细胞周期折返和circASXL1/Ncl/Ribo-bio/胞质分裂的系列信号在心脏修复中起着至关重要的作用。UMSC-Exo通过以circASXL1依赖性方式刺激CM细胞周期折返和胞质分裂来有效修复梗塞心肌。这项研究提供了针对MI的circASXL1信号网络的创新治疗策略,并提供了增强心脏修复的潜在途径。
    Rationale: Myocardial infarction (MI) is a severe global clinical condition with widespread prevalence. The adult mammalian heart\'s limited capacity to generate new cardiomyocytes (CMs) in response to injury remains a primary obstacle in developing effective therapies. Current approaches focus on inducing the proliferation of existing CMs through cell-cycle reentry. However, this method primarily elevates cyclin dependent kinase 6 (CDK6) and DNA content, lacking proper cytokinesis and resulting in the formation of dysfunctional binucleated CMs. Cytokinesis is dependent on ribosome biogenesis (Ribo-bio), a crucial process modulated by nucleolin (Ncl). Our objective was to identify a novel approach that promotes both DNA synthesis and cytokinesis. Methods: Various techniques, including RNA/protein-sequencing analysis, Ribo-Halo, Ribo-disome, flow cytometry, and cardiac-specific tumor-suppressor retinoblastoma-1 (Rb1) knockout mice, were employed to assess the series signaling of proliferation/cell-cycle reentry and Ribo-bio/cytokinesis. Echocardiography, confocal imaging, and histology were utilized to evaluate cardiac function. Results: Analysis revealed significantly elevated levels of Rb1, bur decreased levels of circASXL1 in the hearts of MI mice compared to control mice. Deletion of Rb1 induces solely cell-cycle reentry, while augmenting the Ribo-bio modulator Ncl leads to cytokinesis. Mechanically, bioinformatics and the loss/gain studies uncovered that circASXL1/CDK6/Rb1 regulates cell-cycle reentry. Moreover, Ribo-Halo, Ribo-disome and circRNA pull-down assays demonstrated that circASXL1 promotes cytokinesis through Ncl/Ribo-bio. Importantly, exosomes derived from umbilical cord mesenchymal stem cells (UMSC-Exo) had the ability to enhance cardiac function by facilitating the coordinated signaling of cell-cycle reentry and Ribo-bio/cytokinesis. These effects were attenuated by silencing circASXL1 in UMSC-Exo. Conclusion: The series signaling of circASXL1/CDK6/Rb1/cell-cycle reentry and circASXL1/Ncl/Ribo-bio/cytokinesis plays a crucial role in cardiac repair. UMSC-Exo effectively repairs infarcted myocardium by stimulating CM cell-cycle reentry and cytokinesis in a circASXL1-dependent manner. This study provides innovative therapeutic strategies targeting the circASXL1 signaling network for MI and offering potential avenues for enhanced cardiac repair.
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  • 文章类型: Journal Article
    皮肤作为抵御外部因素的保护屏障起着至关重要的作用,但是破坏其完整性会导致伤口形成并阻碍自然愈合过程。瘢痕形成和延迟的伤口愈合在皮肤损伤治疗中提出了重大挑战。虽然存在替代方法,如皮肤替代品和组织工程,它们通常在可访问性和成本方面受到限制。由于外泌体的再生特性,外泌体已成为伤口愈合的潜在解决方案。
    在这项研究中,使用试剂盒从人血清中分离外泌体。外泌体的特征是,并在体外评估了它们对细胞迁移的影响。此外,使用大鼠全层伤口模型在体内评估外泌体的伤口愈合能力。
    我们的体外研究结果表明,外泌体显著促进细胞迁移。体内实验表明,在伤口的不同区域注射外泌体加速了伤口的愈合过程,导致伤口闭合,胶原蛋白合成,血管形成,和伤口区域的血管生成。这些结果表明外泌体具有加速伤口愈合和最小化瘢痕形成的有希望的治疗潜力。
    这项研究的发现突出了外泌体作为增强伤口愈合的新方法的潜力。在体外和体内研究中,外泌体对细胞迁移和伤口闭合均显示出积极的作用,表明它们作为皮肤损伤的再生疗法的潜在用途。需要进一步的研究来充分了解外泌体对伤口愈合有益作用的潜在机制,并优化其在临床环境中的应用。
    UNASSIGNED: The skin plays a crucial role as a protective barrier against external factors, but disruptions to its integrity can lead to wound formation and hinder the natural healing process. Scar formation and delayed wound healing present significant challenges in skin injury treatment. While alternative approaches such as skin substitutes and tissue engineering exist, they are often limited in accessibility and cost. Exosomes have emerged as a potential solution for wound healing due to their regenerative properties.
    UNASSIGNED: In this study, exosomes were isolated from human blood serum using a kit. The exosomes were characterized, and their effects on cell migration were assessed in vitro. Additionally, the wound healing capacity of exosomes was evaluated in vivo using a rat full-thickness wound model.
    UNASSIGNED: Our in vitro findings revealed that exosomes significantly promoted cell migration. In vivo experiments demonstrated that the injection of exosomes at different areas of the wound accelerated the wound healing process, resulting in wound closure, collagen synthesis, vessel formation, and angiogenesis in the wound area. These results suggest that exosomes have a promising therapeutic potential for expediting wound healing and minimizing scar formation.
    UNASSIGNED: The findings of this study highlight the potential of exosomes as a novel approach for enhancing wound healing. Exosomes showed positive effects on both cell migration and wound closure in in vitro and in vivo studies, suggesting their potential use as a regenerative therapy for skin injuries. Further research is needed to fully understand the mechanisms underlying the beneficial effects of exosomes on wound healing and to optimize their application in clinical settings.
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  • 文章类型: Journal Article
    外泌体是由所有细胞产生的细胞外囊泡,它们携带核酸,蛋白质,脂质,和代谢物。它们介导细胞之间的物质交换,从而影响受体细胞的生物学特性和活性。在这次审查中,我们简要讨论了外泌体的组成和外泌体的分离。我们还回顾了外泌体在癌症生物学中的临床应用以及外泌体介导的靶向药物递送系统的策略。最后,讨论了外泌体在癌症治疗中的应用。
    Exosomes are extracellular vesicles generated by all cells and they carry nucleic acids, proteins, lipids, and metabolites. They mediate the exchange of substances between cells,thereby affecting biological properties and activities of recipient cells. In this review, we briefly discuss the composition of exocomes and exosome isolation. We also review the clinical applications of exosomes in cancer biology as well as strategies in exosome-mediated targeted drug delivery systems. Finally, the application of exosomes in the context of cancer therapeutics both in practice and literature are discussed.
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  • 文章类型: Journal Article
    节段性骨缺损,由于创伤等因素,肿瘤切除,先天性畸形,提出了重大的临床挑战,通常需要复杂的重建策略。负载有多种骨生成促进成分的水凝胶已成为修复骨缺损的有希望的工具。虽然先前已经证明了Piezo1激动剂Yoda1的成骨潜力,其疏水性质对有效加载到水凝胶基质上提出了挑战。在这项研究中,我们通过使用Yoda1预处理的骨髓间充质干细胞(BMSCs)外泌体(Exo-Yoda1)和BMSCs(Exo-MSC)外泌体来应对这一挑战.相对而言,与对照组和Exo-MSC处理的对应物相比,Exo-Yoda1处理的BMSC表现出增强的成骨能力。值得注意的是,Exo-Yoda1处理的细胞表现出与Yoda1本身相似的功能。转录组分析显示成骨相关信号通路的激活,表明Yoda1介导的信号如ErK的潜在转导,这项研究验证了这一发现。此外,我们成功地将Exo-Yoda1整合到明胶甲基丙烯酰(GelMA)/甲基丙烯酸海藻酸钠(SAMA)/β-磷酸三钙(β-TCP)水凝胶中。这些加载Exo-Yoda1的水凝胶在皮下异位成骨裸鼠模型和大鼠颅骨骨缺损模型中显示出增强的成骨作用。总之,我们的研究引入了Exo-Yoda1负载的GELMA/SAMA/β-TCP水凝胶作为促进成骨的有希望的方法。这种创新策略对于骨缺损重建领域的未来广泛临床应用具有重要意义。
    Segmental bone defects, arising from factors such as trauma, tumor resection, and congenital malformations, present significant clinical challenges that often necessitate complex reconstruction strategies. Hydrogels loaded with multiple osteogenesis-promoting components have emerged as promising tools for bone defect repair. While the osteogenic potential of the Piezo1 agonist Yoda1 has been demonstrated previously, its hydrophobic nature poses challenges for effective loading onto hydrogel matrices.In this study, we address this challenge by employing Yoda1-pretreated bone marrow-derived mesenchymal stem cell (BMSCs) exosomes (Exo-Yoda1) alongside exosomes derived from BMSCs (Exo-MSC). Comparatively, Exo-Yoda1-treated BMSCs exhibited enhanced osteogenic capabilities compared to both control groups and Exo-MSC-treated counterparts. Notably, Exo-Yoda1-treated cells demonstrated similar functionality to Yoda1 itself. Transcriptome analysis revealed activation of osteogenesis-associated signaling pathways, indicating the potential transduction of Yoda1-mediated signals such as ErK, a finding validated in this study. Furthermore, we successfully integrated Exo-Yoda1 into gelatin methacryloyl (GelMA)/methacrylated sodium alginate (SAMA)/β-tricalcium phosphate (β-TCP) hydrogels. These Exo-Yoda1-loaded hydrogels demonstrated augmented osteogenesis in subcutaneous ectopic osteogenesis nude mice models and in rat skull bone defect model. In conclusion, our study introduces Exo-Yoda1-loaded GELMA/SAMA/β-TCP hydrogels as a promising approach to promoting osteogenesis. This innovative strategy holds significant promise for future widespread clinical applications in the realm of bone defect reconstruction.
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  • 文章类型: Journal Article
    脱发被认为是一个广泛但令人不安的健康问题,有限的治疗选择。作为来自携带蛋白质的细胞的膜结构,核酸和脂质,外泌体功能性药物细胞间通讯并改变受体细胞的反应,导致疾病的克制或促进。外泌体在疾病的诊断和治疗中具有广阔的前景。使用动物模型和细胞水平的研究清楚地表明,来自几种类型细胞的外泌体,包括毛乳头细胞和间充质干细胞,具有显著的促进头发生长的能力,这表明外泌体可能为治疗脱发提供新的选择。这里,我们对外泌体应用于毛发生长的最新进展进行了全面回顾.
    Alopecia is considered a widespread yet troubling health issue, with limited treatment options. As membranous structures derived from cells carrying proteins, nucleic acids and lipids, exosomes functionally medicate intercellular communication and alter the responses of recipient cells, resulting in disease restraint or promotion. Exosomes have broad prospects in diagnosis and treatment of diseases. Studies using animal models and at the cellular level have clearly shown that exosomes from several types of cells, including dermal papilla cells and mesenchymal stem cells, have a notable capacity to promote hair growth, suggesting that exosomes may provide a new option to treat alopecia. Here, we present a thorough review of the most recent progress in the application of exosomes to hair growth.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是一种使人衰弱的疾病,可导致心肌梗塞(MI)。外来体miRNA(exo-miRNA)可以是用于检测MI的诊断生物标志物。这里,我们进行了一项研究,以评估exo-miRNA-21-5p/3p早期检测MI的功效.
    共有135名CAD患者和150名健康受试者参与了这项研究。此外,我们将26只雄性Wistar大鼠(12周龄)随机分为两组:对照组和诱发MI。使用血管造影图像来识别所有性别的患者和健康个体。在下文中,获得血清外泌体,和exo-miRNA-21-5p/3p通过逆转录酶聚合酶链反应测量。
    我们观察到与对照相比,在CAD患者和MI诱导的动物组中exo-miRNA-21-5p/3p的上调。ROC曲线分析定义了82%和88%的参与者exo-miRNA-21-5p和exo-miRNA-21-3p诊断能力,分别,在动物模型中分别为92和82。
    该研究揭示,在CAD患者和诱发MI的动物模型中,exo-miRNA-21-5p/3p的平均表达水平显著增加。此外,这些结果与CAD患者的动脉粥样硬化脂质分布有关,这可能在疾病的进展中起重要作用。因此,它们可以被认为是新的生物标志物。
    UNASSIGNED: Coronary artery disease (CAD) is a debilitating condition that can lead to myocardial infarction (MI). Exosomal miRNAs (exo-miRNA) can be diagnostic biomarkers for detecting MI. Here, we conduct a study to evaluate the efficacy of exo-miRNA-21-5p/3p for early detection of MI.
    UNASSIGNED: A total of 135 CAD patients and 150 healthy subjects participated in this study. Additionally, we randomly divided 26 male Wistar rats (12 weeks old) into two groups: control and induced MI. Angiographic images were used to identify patients and healthy individuals of all genders. In the following, serum exosomes were obtained, and exo-miRNA-21-5p/3p was measured by reverse-transcriptase polymerase chain reaction.
    UNASSIGNED: We observed an upregulation of exo-miRNA-21-5p/3p in CAD patient and MI-induced animal groups compared to controls. Analysis of the ROC curves defined 82% and 88% of the participants\' exo-miRNA-21-5p and exo-miRNA-21-3p diagnostic power, respectively, which in the animal model was 92 and 82.
    UNASSIGNED: This study revealed that the mean expression levels of exo-miRNA-21-5p/3p were significantly increased in CAD patients and animal models of induced MI. Also, these results are associated with the atherogenic lipid profile of CAD patients, which may play an important role in the progression of the disease. Therefore, they can be considered as novel biomarkers.
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  • 文章类型: Journal Article
    头颈部鳞状细胞癌(HNSCC)是全球癌症负担,5年总生存率约为50%。停滞了几十年。肿瘤诱导的免疫抑制微环境有助于HNSCC进展,腺苷(ADO)途径和抑制性免疫检查点调节因子的上调表达在这方面起关键作用。高中性粒细胞与淋巴细胞比率(NLR)与晚期肿瘤分期之间的相关性表明中性粒细胞(NØ)参与了癌症进展。有趣的是,我们将高NLR与原代HNSCC样品中细胞内PD-L1定位增加相关联,可能介导更具侵袭性的肿瘤特征,因此协同促进肿瘤进展。尽管如此,需要进一步的研究来利用这些知识进行有效的治疗并克服耐药性。由于假设肿瘤微环境(TME)可能受到肿瘤(TEX)分泌的小细胞外囊泡(sEV)的影响,这项研究旨在研究HNSCC衍生的TEX对NØ的影响以及阻断ADO受体作为逆转NØ肿瘤前表型的潜在策略。UMSCC47-TEX表现出参与ADO信号传导的CD73酶活性,以及免疫检查点抑制剂PD-L1。数据显示,TEX诱导NØ的趋化性,持续的相互作用促进了向肿瘤前表型的转变,依赖ADO受体(P1R),增加CD170high亚群,CD73和PD-L1表达,其次是一个免疫抑制的分泌体。阻断A3R降低CD73和PD-L1表达。与HNSCC细胞的共培养实验表明,TEX调节的NO可增加CD73/PD-L1轴,通过细胞周期蛋白D-CDK4/6信号传导。为了支持这些发现,具有原发性肿瘤的CAM模型用N.0上清液处理。此外,这些NØ促进了移民的增加,入侵,减少细胞死亡。瞄准NØ上的P1R,尤其是A3R,表现出潜在的治疗策略来对抗HNSCC的免疫抑制。了解TEX介导的肿瘤和NØ之间的串扰提供了对免疫调节改善癌症治疗的见解。
    Head and neck squamous cell carcinoma (HNSCC) is a global cancer burden with a 5-year overall survival rate of around 50%, stagnant for decades. A tumour-induced immunosuppressive microenvironment contributes to HNSCC progression, with the adenosine (ADO) pathway and an upregulated expression of inhibitory immune checkpoint regulators playing a key role in this context. The correlation between high neutrophil-to-lymphocyte ratio (NLR) with advanced tumour staging suggests involvement of neutrophils (NØ) in cancer progression. Interestingly, we associated a high NLR with an increased intracellular PD-L1 localization in primary HNSCC samples, potentially mediating more aggressive tumour characteristics and therefore synergistically favouring tumour progression. Still, further research is needed to harness this knowledge for effective treatments and overcome resistance. Since it is hypothesized that the tumour microenvironment (TME) may be influenced by small extracellular vesicles (sEVs) secreted by tumours (TEX), this study aims to investigate the impact of HNSCC-derived TEX on NØ and blockade of ADO receptors as a potential strategy to reverse the pro-tumour phenotype of NØ. UMSCC47-TEX exhibited CD73 enzymatic activity involved in ADO signalling, as well as the immune checkpoint inhibitor PD-L1. Data revealed that TEX induce chemotaxis of NØ and the sustained interaction promotes a shift into a pro-tumour phenotype, dependent on ADO receptors (P1R), increasing CD170high subpopulation, CD73 and PD-L1 expression, followed by an immunosuppressive secretome. Blocking A3R reduced CD73 and PD-L1 expression. Co-culture experiments with HNSCC cells demonstrated that TEX-modulated NØ increase the CD73/PD-L1 axis, through Cyclin D-CDK4/6 signalling. To support these findings, the CAM model with primary tumour was treated with NØ supernatant. Moreover, these NØ promoted an increase in migration, invasion, and reduced cell death. Targeting P1R on NØ, particularly A3R, exhibited potential therapeutic strategy to counteract immunosuppression in HNSCC. Understanding the TEX-mediated crosstalk between tumours and NØ offers insights into immunomodulation for improving cancer therapies.
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  • 文章类型: Journal Article
    糖尿病肾病(DN)代表主要的慢性肾病和终末期肾病(ESRD)的主要原因。小RNA已经显示出作为诊断标记和药物靶标的巨大前景。识别失调的微小RNA(miRNA)可以帮助识别疾病生物标志物和下游相互作用的研究。阐明DN的分子病理生理学。在这项研究中,我们使用小RNA下一代测序分析了DN患者的人尿细胞外囊泡(ECV)中的小RNA.
    在这项横断面研究中,从88名参与者中收集尿液样本,这些参与者分为3组:2型糖尿病(T2D)合并DN(T2D+DN,n=20),不带DN的T2D(T2D-DN,n=40),和健康个体(n=28)。该研究集中于分离尿ECV以提取和测序小RNA。差异表达的小RNA被鉴定,并进行了功能富集分析。
    该研究揭示了13个miRNA和10个Piwi相互作用的RNA的不同子集,与其他组相比,它们在DN组的尿ECV中明显失调。值得注意的是,miR-151a-3p和miR-182-5p表现出独特的表达模式,在T2D-DN组中下调,并在T2D+DN组中上调,从而证明了它们在区分两组患者方面的有效性。八个驱动基因被鉴定为PTEN,SMAD2,SMAD4,VEGFA,CCND2,CDK6,LIN28B,和CHD1。
    我们的发现为DN的发病机制提供了宝贵的见解,发现新的生物标志物,并确定可能有助于控制和减缓疾病进展的潜在治疗靶点。
    UNASSIGNED: Diabetic nephropathy (DN) represents a major chronic kidney disorder and a leading cause of end-stage renal disease (ESRD). Small RNAs have been showing great promise as diagnostic markers as well as drug targets. Identifying dysregulated micro RNAs (miRNAs) could help in identifying disease biomarkers and investigation of downstream interactions, shedding light on the molecular pathophysiology of DN. In this study, we analyzed small RNAs within human urinary extracellular vesicles (ECVs) from DN patients using small RNA next-generation sequencing.
    UNASSIGNED: In this cross-sectional study, urine samples were collected from 88 participants who were divided into 3 groups: type 2 diabetes (T2D) with DN (T2D + DN, n = 20), T2D without DN (T2D - DN, n = 40), and healthy individuals (n = 28). The study focused on isolating urinary ECVs to extract and sequence small RNAs. Differentially expressed small RNAs were identified, and a functional enrichment analysis was conducted.
    UNASSIGNED: The study revealed a distinct subset of 13 miRNAs and 10 Piwi-interacting RNAs that were significantly dysregulated in urinary ECVs of the DN group when compared to other groups. Notably, miR-151a-3p and miR-182-5p exhibited a unique expression pattern, being downregulated in the T2D - DN group, and upregulated in the T2D + DN group, thus demonstrating their effectiveness in distinguishing patients between the 2 groups. Eight driver genes were identified PTEN, SMAD2, SMAD4, VEGFA, CCND2, CDK6, LIN28B, and CHD1.
    UNASSIGNED: Our findings contribute valuable insights into the pathogenesis of DN, uncovering novel biomarkers and identifying potential therapeutic targets that may aid in managing and potentially decelerating the progression of the disease.
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  • 文章类型: Journal Article
    外泌体是在多囊膜和质膜融合后释放到周围体液中的天然存在的细胞外囊泡(EV)。它们通过运输DNA促进细胞间的通讯,mRNAmicroRNA,长链非编码RNA,环状RNA,蛋白质,脂质,和核酸。它们有助于中枢神经系统(CNS)肿瘤的发作和进展。此外,它们可以用作肿瘤增殖的生物标志物,迁移,血管的形成,从而影响肿瘤微环境(TME)。本文综述了外泌体在各种中枢神经系统肿瘤中的诊断和治疗的最新进展。外泌体作为中枢神经系统肿瘤的天然载体的前景和挑战,以及外泌体在中枢神经系统肿瘤中的治疗前景。此外,我们希望这项研究能够有助于开发更有针对性和有效的中枢神经系统肿瘤治疗方法。
    Exosomes are naturally present extracellular vesicles (EVs) released into the surrounding body fluids upon the fusion of polycystic and plasma membranes. They facilitate intercellular communication by transporting DNA, mRNA, microRNA, long non-coding RNA, circular RNA, proteins, lipids, and nucleic acids. They contribute to the onset and progression of Central Nervous System (CNS) tumors. In addition, they can be used as biomarkers of tumor proliferation, migration, and blood vessel formation, thereby affecting the Tumor Microenvironment (TME). This paper reviews the recent advancements in the diagnosis and treatment of exosomes in various CNS tumors, the promise and challenges of exosomes as natural carriers of CNS tumors, and the therapeutic prospects of exosomes in CNS tumors. Furthermore, we hope this research can contribute to the development of more targeted and effective treatments for central nervous system tumors.
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  • 文章类型: Journal Article
    如今,很明显,细胞外囊泡(EV)不是细胞废物处理囊泡,而是细胞间通讯系统的重要组成部分。除了在生物标志物研究和诊断中使用电动汽车之外,许多人已经看到了EV疗法的潜力。它们为疾病治疗提供了独特的特性,包括强大的免疫调节作用,工程的可能性,低免疫原性,以及跨越生物屏障的能力。在临床前研究中已经实现了用于各种病理的EV疗法的概念证明。然而,电动汽车的临床试验只是缓慢出现。这里,我们的目标是全面概述目前在人类治疗中使用EV的临床研究的最新水平.通过系统地接近当前的知识,我们纳入了21份报告,用于安全性荟萃分析和疗效结局评价.总的来说,我们已经表明,基于EV的治疗是安全的,严重不良事件的发生率低(SAE;0.7%(95%-CI:0.1-5.2%),和不良事件(AE;4.4%(95%-CI:0.7-22.2%)。亚组分析显示,当比较自体与同种异体给药时,SAE没有显着差异,以及工程和非工程电动汽车产品。在自体与同种异体给药中观察到显著较高数量的AE。然而,临床相关性仍然值得怀疑。评估免疫刺激的临床结果,免疫抑制或再生EV治疗表明大多数接受治疗的患者有所改善.尽管这些有希望的结果,由于电动汽车制造方法的高度异质性,需要谨慎对待数据,研究设计,并报告(S)AE。总的来说,我们得出的结论是,基于EV的治疗是安全的,并且是一个有希望的治疗机会.需要在EV隔离和表征数据的报告的标准化和协调以及(S)AE的报告方面做出更多努力,以进行研究间比较。
    Nowadays, it has become clear that extracellular vesicles (EVs) are not a cellular waste disposal vesicle but are an essential part of an intercellular communication system. Besides the use of EVs in biomarker studies and diagnostics, the potential of EV-therapeutics has been seen by many. They provide unique properties for disease therapy, including strong immune-modulatory actions, the possibility of engineering, low immunogenicity, and the capability of crossing biological barriers. Proof-of-concept of EV-therapeutics for various pathologies has been achieved in preclinical studies. However, clinical trials with EVs have only been emerging slowly. Here, we aim to provide a comprehensive overview of the current state-of-the-art concerning clinical studies using EVs in human therapy. By approaching the current knowledge in a systematic manner, we were able to include 21 reports for meta-analysis of safety and evaluation of efficacy outcomes. Overall, we have shown that EV-based therapy is safe with a low incidence of serious adverse events (SAE; 0.7% (95%-CI: 0.1-5.2%), and adverse events (AE; 4.4% (95%-CI: 0.7-22.2%). Subgroup analysis showed no significant difference in SAE when comparing autologous versus allogeneic administration, as well as engineered versus non-engineered EV products. A significantly higher number of AE was seen in autologous versus allogeneic administration. However, the clinical relevance remains questionable. Evaluation of the clinical outcomes of immunostimulatory, immunosuppressive or regenerative EV-therapies indicated improvement in the majority of treated patients. Despite these promising results, data need to be approached with caution due to a high heterogeneity in the EVs manufacturing methods, study design, and reporting of (S)AE. Overall, we conclude that EV-based therapy is safe and presents a promising opportunity in therapy. More efforts are needed in the standardization and harmonization of reporting of EV isolation and characterization data as well as in the reporting of (S)AE to allow inter-study comparison.
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