Basic Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Sep 26, 2023; 15(9): 897-907
Published online Sep 26, 2023. doi: 10.4252/wjsc.v15.i9.897
Mechanism of adipose-derived mesenchymal stem cell exosomes in the treatment of heart failure
Lei Wang, Jin-Jin Zhang, Sha-Sha Wang, Liang Li
Lei Wang, Jin-Jin Zhang, Sha-Sha Wang, Liang Li, Department of Geriatric Medicine, Fourth Medical Center of PLA General Hospital, Beijing 100048, China
Author contributions: Wang L, Zhang JJ, and Wang SS contributed equally to this work and are co-first authors. Wang L, Zhang JJ, and Wang SS proposed the overall research goal and designed the research plan and model design, conducted statistical processing and analysis of the data, and are responsible for writing the first draft of the paper; Wang L, Zhang JJ, Wang SS, and Li L conducted feasibility analysis, review and supervision of the experiment; and are responsible for the review, revision and quality control of the paper; and all authors determined the final draft of the paper.
Institutional animal care and use committee statement: This study was approved by the Experimental Animal Ethics Committee of Fourth Medical Center of PLA General Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
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:
Corresponding author: Liang Li, MM, Doctor, Department of Geriatric Medicine, Fourth Medical Center of PLA General Hospital, No. 51 Fucheng road, Haidian District, Beijing 100048, China.
Received: July 27, 2023
Peer-review started: July 27, 2023
First decision: August 3, 2023
Revised: August 16, 2023
Accepted: September 12, 2023
Article in press: September 12, 2023
Published online: September 26, 2023

Heart failure (HF) is a global health problem characterized by impaired heart function. Cardiac remodeling and cell death contribute to the development of HF. Although treatments such as digoxin and angiotensin receptor blocker drugs have been used, their effectiveness in reducing mortality is uncertain. Researchers are exploring the use of adipose-derived mesenchymal stem cell (ADMSC) exosomes (Exos) as a potential therapy for HF. These vesicles, secreted by cells, may aid in tissue repair and regulation of inflammation and immune responses. However, further investigation is needed to understand the specific role of these vesicles in HF treatment.


To investigate the mechanism of extracellular vesicles produced by ADMSC s in the treatment of HF.


Exogenous surface markers of ADMSCs were found, and ADMSCs were cultured.


The identification of surface markers showed that the surface markers CD44 and CD29 of adipose-derived stem cells (ADSCs) were well expressed, while the surface markers CD45 and CD34 of ADSCs were negative, so the cultured cells were considered ADSCs. Western blotting detected the Exo surface marker protein, which expressed CD63 protein but did not express calnexin protein, indicating that ADSC-derived Exos were successfully extracted.


The secretion of MSCs from adipose tissue can increase ATP levels, block cardiomyocyte apoptosis, and enhance the heart function of animals susceptible to HF. The inhibition of Bax, caspase-3 and p53 protein expression may be related to this process.

Keywords: Adipose-derived mesenchymal stem cell exosomes, Heart failure, Cardiomyocyte apoptosis

Core Tip: Our study highlights the potential of mesenchymal stem cell exosomes (Exos) from adipose tissue as a promising therapy for heart failure (HF). Administration of adipose-derived mesenchymal stem cell Exos improved cardiac function, evidenced by increased ATP content and enhanced parameters like ejection fraction, fractional shortening, and stroke volume. Furthermore, adipose-derived stem cells (ADSCs)-Exo reduced serum levels of b-type natriuretic peptide and atrial natriuretic peptide, associated with HF progression, and exhibited anti-apoptotic effects by regulating pro- and anti-apoptotic proteins in cardiac tissue. These findings suggest that ADSCs-Exo could prevent cardiomyocyte death and inhibit HF progression.