Extracellular vesicles (EVs) released from cells play vital roles in intercellular communication. Moreover, EVs released from stem cells have therapeutic properties. This review confers the potential of brain-derived EVs in the cerebrospinal fluid (CSF) and the serum as sources of epilepsy-related biomarkers, and the promise of mesenchymal stem cell (MSC)-derived EVs for easing status epilepticus (SE)-induced adverse changes in the brain. Extracellular vesicles shed from neurons and glia in the brain can also be found in the circulating blood as EVs cross the blood-brain barrier (BBB). Evaluation of neuron and/or glia-derived EVs in the blood of patients who have epilepsy could help in identifying specific biomarkers for distinct types of epilepsies. Such a liquid biopsy approach is also amenable for repeated analysis in clinical trials for comprehending treatment efficacy, disease progression, and mechanisms of therapeutic interventions. Extracellular vesicle biomarker studies in animal prototypes of epilepsy, in addition, could help in identifying specific micro ribonucleic acid (miRNAs) contributing to epileptogenesis, seizures, or cognitive dysfunction in different types of epilepsy. Furthermore, intranasal (IN) administration of MSC-derived EVs after SE has shown efficacy for restraining SE-induced neuroinflammation, aberrant neurogenesis, and cognitive dysfunction in an animal prototype. Clinical translation of EV therapy as an adjunct to antiepileptic drugs appears attractive to counteract the progression of SE-induced epileptogenic changes, as the risk for thrombosis or tumor is minimal with nanosized EVs. Also, EVs can be engineered to deliver specific miRNAs, proteins, or antiepileptic drugs to the brain since they incorporate into neurons and glia throughout the brain after IN administration. This article is part of the Special Issue "NEWroscience 2018".

中文翻译：

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细胞外囊泡用于诊断和治疗癫痫的前景

从细胞释放的细胞外囊泡 (EV) 在细胞间通讯中起着至关重要的作用。此外，从干细胞释放的 EVs 具有治疗特性。本综述认为脑脊液 (CSF) 和血清中的脑源性 EVs 作为癫痫相关生物标志物的来源的潜力，以及间充质干细胞 (MSC) 源性 EVs 缓解癫痫持续状态 (SE) 诱导的前景。大脑的不良变化。当 EV 穿过血脑屏障 (BBB) 时，在循环血液中也可以发现从大脑中的神经元和神经胶质脱落的细胞外囊泡。对癫痫患者血液中神经元和/或神经胶质衍生的 EV 的评估有助于确定不同类型癫痫的特定生物标志物。这种液体活检方法也适用于临床试验中的重复分析，以了解治疗效果、疾病进展和治疗干预机制。此外，对癫痫动物原型进行的细胞外囊泡生物标志物研究有助于识别特定的微核糖核酸 (miRNA)，这些微核糖核酸 (miRNA) 有助于不同类型癫痫的癫痫发生、癫痫发作或认知功能障碍。此外，在 SE 后鼻内 (IN) 施用 MSC 衍生的 EV 已显示出抑制动物原型中 SE 诱导的神经炎症、异常神经发生和认知功能障碍的功效。EV 疗法作为抗癫痫药物的辅助治疗的临床转化似乎对抵消 SE 诱导的癫痫发作的进展具有吸引力，因为使用纳米尺寸的电动汽车，血栓形成或肿瘤的风险很小。此外，EV 可以被设计为向大脑输送特定的 miRNA、蛋白质或抗癫痫药物，因为它们在 IN 给药后整合到整个大脑的神经元和神经胶质中。本文是特刊“NEWroscience 2018”的一部分。