Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Apr 26, 2025; 17(4): 102421
Published online Apr 26, 2025. doi: 10.4252/wjsc.v17.i4.102421
Effectiveness of mesenchymal stem cell-derived extracellular vesicles therapy for Parkinson’s disease: A systematic review of preclinical studies
Xue-Song Wang, Yue Wang, Yan Xu, Shan-Rong Zhang, Yang Zhang, Lu-Lu Peng, Nan Wu, Jun-Song Ye
Xue-Song Wang, Yue Wang, Yan Xu, Shan-Rong Zhang, Lu-Lu Peng, Jun-Song Ye, Subcenter for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Xue-Song Wang, Yan Xu, Shan-Rong Zhang, Yang Zhang, School of Rehabilitation Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Xue-Song Wang, Yan Xu, Shan-Rong Zhang, Jun-Song Ye, Ganzhou Key Laboratory of Stem Cell and Regenerative Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Yue Wang, College of Nursing, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Shan-Rong Zhang, Lu-Lu Peng, Nan Wu, First Clinical Medical College of Gannan Medical University, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Jun-Song Ye, Jiangxi Provincial Key Laboratory of Tissue Engineering, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Jun-Song Ye, Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Author contributions: Xu Y and Zhang SR collected the data; Wang XS and Wang Y analyzed the data; Wang XS, Wang Y, Zhang Y, Peng LL, and Wu N contributed to the reagents, materials, and analysis tools; Wang XS wrote the manuscript; Wang XS and Wang Y contributed to the figures and tables; Ye JS provided financial support and conducted the final review of the manuscript; All authors contributed to the article and agreed to submit the manuscript.
Supported by the National Natural Science Foundation of China, No. 32060232; and the Natural Science Foundation of Jiangxi Province, No. 20212BAB206075.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Jun-Song Ye, MD, PhD, Chief Physician, Professor, Subcenter for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, No. 23 Qingnian Road, Ganzhou 341000, Jiangxi Province, China. yjs1211@163.com
Received: October 18, 2024
Revised: January 23, 2025
Accepted: March 3, 2025
Published online: April 26, 2025
Processing time: 187 Days and 23.6 Hours
Abstract
BACKGROUND

Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) can traverse the blood-brain barrier due to their small size. This characteristic makes them a research hotspot for the treatment of Parkinson’s disease (PD) and is expected to be a potentially revolutionary strategy for treating PD. Despite this, no summary of clinical trial results has been reported.

AIM

To assess the efficacy and durability of MSC-EVs in treating PD.

METHODS

Systematic searches were conducted in four electronic databases until June 2024 to collect studies on the use of MSC-EVs for this purpose. Thirteen relevant randomized controlled trials, encompassing 16 experiments, were selected for inclusion.

RESULTS

Behavioral assessments, including the rotarod and apomorphine turning behavior tests, indicated improvements in motor coordination (P < 0.00001); the Pole test and the Wire-hang test showed enhanced limb motor agility and synchronization (P = 0.003 and P < 0.00001, respectively). Histopathologically, there was a reduction in inflammatory markers such as tumor necrosis factor-α and interleukin-6 (P = 0.03 and P = 0.01, respectively) and an increase in tyrosine hydroxylase-positive cells in the lesion areas (P < 0.00001).

CONCLUSION

MSC-EV therapy for PD is a gradual process, with significant improvements observable more than 2 weeks after administration and lasting at least 8 weeks. This study is the first to demonstrate the efficacy and durability of MSC-EV treatment in PD.

Keywords: Mesenchymal stem cell; Extracellular vesicles; Exosomes; Stem cell therapy; Parkinson’s disease; Systematic review

Core Tip: Mesenchymal stem cell extracellular vesicles (MSC-EVs) have become a popular direction for tissue engineering research in recent years and have been shown to have many advantages, especially in neurological diseases. Unfortunately, the treatment of Parkinson’s disease (PD) with MSC-EVs is still in the clinical void stage due to insufficient guideline protocols. Our study was the first to validate the efficacy and durability of MSC-EVs in the treatment of PD and to draw a number of valuable guiding conclusions. The results of our analyses are of great reference value for future clinical translation of stem cell exosomes for PD.