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World J Stem Cells. Jun 26, 2023; 15(6): 561-575
Published online Jun 26, 2023. doi: 10.4252/wjsc.v15.i6.561
Potential regulatory effects of stem cell exosomes on inflammatory response in ischemic stroke treatment
Na Chen, Yan-Lin Wang, Hui-Fang Sun, Zhuo-Ya Wang, Qi Zhang, Fei-Yan Fan, Yu-Cheng Ma, Fei-Xiang Liu, Yun-Ke Zhang
Na Chen, Fei-Yan Fan, Yu-Cheng Ma, First School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou 450046, Henan Province, China
Yan-Lin Wang, Hui-Fang Sun, Zhuo-Ya Wang, Qi Zhang, Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Fei-Xiang Liu, Yun-Ke Zhang, Department of Neurology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China
Yun-Ke Zhang, School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou 450008, Henan Province, China
Author contributions: Chen N drafted the manuscript; Wang YL, Sun HF, Wang ZY, and Zhang Q reviewed the literature, and designed and revised the manuscript; Fan FY, Liu FX, and Ma YC generated the graphs; Zhang YK guided the construction of the manuscript; all the authors have read and approved the manuscript.
Supported by the National Natural Science Foundation of China, No. 81974564 and No. 82104730; the Zhongyuan Science and Technology Innovation Leading Talent Project, No. 224200510027; the National Natural Science Foundation of China, No. 82001973; the Youth Project Co-established by Henan Province and a Ministry grant, No. SBGJ2020003017; and the Health Science and Technology Innovation Excellent Youth Training Project in Henan Province, No. YXKC2020057.
Conflict-of-interest statement: The authors declare no conflict of interest. The funding body played no role in the design of the study; collection, analysis, and interpretation of data; or in writing the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Ke Zhang, PhD, Doctor, School of Rehabilitation Medicine, Henan University of Chinese Medicine, No. 156 Jinshui East Road, Zhengdong New District, Zhengzhou 450008, Henan Province, China. henanzyk@126.com
Received: January 7, 2023
Peer-review started: January 7, 2023
First decision: April 10, 2023
Revised: April 22, 2023
Accepted: May 16, 2023
Article in press: May 16, 2023
Published online: June 26, 2023
Processing time: 170 Days and 11.8 Hours
Abstract

The high incidence and disability rates of stroke pose a heavy burden on society. Inflammation is a significant pathological reaction that occurs after an ischemic stroke. Currently, therapeutic methods, except for intravenous thrombolysis and vascular thrombectomy, have limited time windows. Mesenchymal stem cells (MSCs) can migrate, differentiate, and inhibit inflammatory immune responses. Exosomes (Exos), which are secretory vesicles, have the characteristics of the cells from which they are derived, making them attractive targets for research in recent years. MSC-derived exosomes can attenuate the inflammatory response caused by cerebral stroke by modulating damage-associated molecular patterns. In this review, research on the inflammatory response mechanisms associated with Exos therapy after an ischemic injury is discussed to provide a new approach to clinical treatment.

Keywords: Mesenchymal stem cell-derived exosome, MicroRNA, Inflammation, Ischemic stroke, Adipose-derived stem cell, Toll-like receptor

Core Tip: Mesenchymal stem cell-derived exosome (MSC-Exos) transplantation is a novel treatment method for ischemic stroke that exhibits certain achievements in trials. Here, we review the strategies developed for MSC-Exos in the neuroinflammatory response of patients with stroke and provide potential therapeutic targets. These methods provide new insights for the future clinical application of MSC-Exos in the treatment of ischemic stroke.