Mesenchymal stem cells (MSC) are, due to their immunosuppressive and regenerative properties, used as new therapeutic agents in cell-based therapy of inflammatory and degenerative diseases. A large number of experimental and clinical studies revealed that most of MSC-mediated beneficial effects were attributed to the effects of MSC-sourced exosomes (MSC-Exos). MSC-Exos are nano-sized extracellular vesicles that contain MSC-derived bioactive molecules (messenger RNA (mRNA), microRNAs (miRNAs)), enzymes, cytokines, chemokines, and growth factors) that modulate phenotype, function and homing of immune cells, and regulate survival and proliferation of parenchymal cells. In this review article, we emphasized current knowledge about molecular and cellular mechanisms that were responsible for MSC-Exos-based beneficial effects in experimental models and clinical trials. Additionally, we elaborated on the challenges of conventional MSC-Exos administration and proposed the use of new bioengineering and cellular modification techniques which could enhance therapeutic effects of MSC-Exos in alleviation of inflammatory and degenerative diseases.

中文翻译：

---

间充质干细胞衍生外泌体的治疗用途：从基础科学到临床。

由于其免疫抑制和再生特性，间充质干细胞（MSC）在基于细胞的炎症和退行性疾病治疗中被用作新的治疗剂。大量实验和临床研究表明，大多数MSC介导的有益作用归因于MSC来源的外泌体（MSC-Exos）的作用。MSC-Exos是纳米级的细胞外囊泡，其中包含MSC衍生的生物活性分子（信使RNA（mRNA），microRNA（miRNA）），酶，细胞因子，趋化因子和生长因子，这些因子可调节免疫细胞的表型，功能和归巢，并调节实质细胞的存活和增殖。在这篇评论文章中，我们强调了有关分子和细胞机制的最新知识，这些分子和细胞机制在实验模型和临床试验中对基于MSC-Exos的有益作用负责。此外，我们详细阐述了常规MSC-Exos给药的挑战，并提出了使用新的生物工程和细胞修饰技术来增强MSC-Exos减轻炎性和退行性疾病的治疗效果的建议。