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Stem Cell-Derived Exosomes as Treatment for Stroke: a Systematic Review

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Abstract

Background

The therapeutic potential of stem cells may largely be mediated by paracrine factors contained in exosomes released from intracellular endosomes. A systematic review was performed to identify the effects of stem cell-derived exosomes for their ability to induce restorative effects in animal models of stroke.

Methods

PubMed, Scopus, and ISI Web of Science databases were searched for all available articles testing stem cell-derived exosomes as therapeutic interventions in animal models of stroke until April 2020. The STAIR scale was used to assess the quality of the included studies.

Results

A total of 994 published articles were identified in the systematic search. After screening for eligibility, a total of 16 datasets were included. Type of cerebral ischemia was transient in majority studies and most studies used rat or mice adipose tissue-derived stem cells/bone marrow-derived stem cells. Eight studies indicated improved functional recovery while 8 were able to show reduced infarct volume as a result of exosome therapy. The beneficial effects were mainly attributed to reduced inflammation and oxidative stress, enhanced neurogenesis, angiogenesis, and neurite remodeling. Also, 4 studies demonstrated that exosomes hold great promise as an endogenous drug delivery nano-system.

Conclusion

In preclinical studies, use of stem cell-derived exosomes is strongly associated with improved neurological recovery and reduced brain infarct volume following stroke. Improved preclinical study quality in terms of treatment allocation reporting, randomization and blinding will accelerate needed progress towards clinical trials that should assess feasibility and safety of this therapeutic approach in humans.

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Acknowledgements

This study is related to the project NO. 1398/9887 from Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran. We also appreciate the “Student Research Committee” and “Research & Technology Chancellor” in Shahid Beheshti University of Medical Sciences for their financial support of this study.

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Authors and Affiliations

  1. Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Leila Dehghani, Seyed Mahmoud Hashemi, Saeed Heidari Keshel, Arash Khojasteh & Masoud Soleimani

  2. Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Seyed Mahmoud Hashemi

  3. Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammad Saadatnia

  4. Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Alireza Zali & Saeed Oraee-Yazdani

  5. Department of Hematology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

    Masoud Soleimani

  6. Medical Nanotechnology and Tissue engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Masoud Soleimani

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  1. Leila Dehghani
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Correspondence to Arash Khojasteh.

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This article belongs to the Topical Collection Special Issue on Exosomes and Microvesicles: from Stem Cell Biology to Translation in Human Diseases

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Dehghani, L., Hashemi, S., Saadatnia, M. et al. Stem Cell-Derived Exosomes as Treatment for Stroke: a Systematic Review. Stem Cell Rev and Rep 17, 428–438 (2021). https://doi.org/10.1007/s12015-020-10024-7

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