Mesenchymal stem cells (MSCs) have been used to treat patients suffering from acute myocardial infarction (AMI) and subsequent heart failure. Although it was originally assumed that MSCs differentiated into heart cells such as cardiomyocytes, recent evidence suggests that the differentiation capacity of MSCs is minimal and that injected MSCs restore cardiac function via the secretion of paracrine factors. MSCs secrete paracrine factors in not only naked forms but also membrane vesicles including exosomes containing bioactive substances such as proteins, messenger RNAs, and microRNAs. Although the details remain unclear, these bioactive molecules are selectively sorted in exosomes that are then released from donor cells in a regulated manner. Furthermore, exosomes are specifically internalized by recipient cells via ligand-receptor interactions. Thus, exosomes are promising natural vehicles that stably and specifically transport bioactive molecules to recipient cells. Indeed, stem cell-derived exosomes have been successfully used to treat cardiovascular disease (CVD), such as AMI, stroke, and pulmonary hypertension, in animal models, and their efficacy has been demonstrated. Therefore, exosome administration may be a promising strategy for the treatment of CVD. Furthermore, modifications of exosomal contents may enhance their therapeutic effects. Future clinical studies are required to confirm the efficacy of exosome treatment for CVD.

中文翻译：

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干细胞衍生的外来体可作为治疗心血管疾病的工具。

间充质干细胞（MSCs）已用于治疗患有急性心肌梗塞（AMI）和随后的心力衰竭的患者。尽管最初假设MSC分化为心脏细胞（如心肌细胞），但最近的证据表明MSC的分化能力极低，并且注射的MSC通过旁分泌因子的分泌恢复了心脏功能。MSC不仅以裸露形式分泌旁分泌因子，而且还分泌膜囊泡，包括含有生物活性物质（如蛋白质，信使RNA和微RNA）的外泌体。尽管细节仍不清楚，但是这些生物活性分子在外泌体中有选择地分类，然后以调节的方式从供体细胞中释放出来。此外，外泌体通过配体-受体相互作用被受体细胞特异性内化。因此，外来体是有前途的天然载体，其可以稳定且特异性地将生物活性分子转运至受体细胞。实际上，干细胞衍生的外泌体已成功用于动物模型中的心血管疾病（CVD），如AMI，中风和肺动脉高压的治疗，其功效已得到证明。因此，外来体给药可能是治疗CVD的有前途的策略。此外，外泌体内容物的修饰可以增强其治疗效果。需要进一步的临床研究来确认外来体治疗CVD的功效。和肺动脉高压，在动物模型中，其功效已得到证实。因此，外来体给药可能是治疗CVD的有前途的策略。此外，外泌体内容物的修饰可以增强其治疗效果。需要进一步的临床研究来确认外来体治疗CVD的功效。和肺动脉高压，在动物模型中，其功效已得到证实。因此，外来体给药可能是治疗CVD的有前途的策略。此外，外泌体内容物的修饰可以增强其治疗效果。需要进一步的临床研究来确认外来体治疗CVD的功效。