Bone marrow-derived mesenchymal stem cells (MSCs) have successfully progressed to phase III clinical trials successive to an intensive in vitro and pre-clinical assessment in experimental animal models of ischemic myocardial injury. With scanty evidence regarding their cardiogenic differentiation in the recipient patients' hearts post-engraftment, paracrine secretion of bioactive molecules is being accepted as the most probable underlying mechanism to interpret the beneficial effects of cell therapy. Secretion of small non-coding microRNA (miR) constitutes an integral part of the paracrine activity of stem cells, and there is emerging interest in miRs' delivery to the heart as part of cell-free therapy to exploit their integral role in various cellular processes. MSCs also release membrane vesicles of diverse sizes loaded with a wide array of miRs as part of their paracrine secretions primarily for intercellular communication and to shuttle genetic material. Exosomes can also be loaded with miRs of interest for delivery to the organs of interest including the heart, and hence, exosome-based cell-free therapy is being assessed for cell-free therapy as an alternative to cell-based therapy. This review of literature provides an update on cell-free therapy with primary focus on exosomes derived from BM-derived MSCs for myocardial repair.

中文翻译：

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用干细胞衍生的外泌体对受伤的心脏进行微缩：一种新兴的无细胞治疗策略。


骨髓间充质干细胞（MSC）已成功进入 III 期临床试验，并在缺血性心肌损伤的实验动物模型中进行了密集的体外和临床前评估。由于关于植入后受体患者心脏中的心源性分化的证据很少，生物活性分子的旁分泌分泌被认为是解释细胞治疗有益效果的最可能的潜在机制。小非编码 microRNA (miR) 的分泌构成干细胞旁分泌活性的一个组成部分，人们对将 miR 作为无细胞治疗的一部分输送到心脏以利用其在各种细胞过程中的不可或缺的作用产生了兴趣。 MSC 还释放不同大小的膜囊泡，其中装载有多种 miR，作为其旁分泌分泌物的一部分，主要用于细胞间通讯和运送遗传物质。外泌体还可以装载感兴趣的 miR，以递送到包括心脏在内的感兴趣器官，因此，正在评估基于外泌体的无细胞疗法作为无细胞疗法的替代方案。这篇文献综述提供了无细胞疗法的最新进展，主要关注来自骨髓间充质干细胞的外泌体用于心肌修复。