bims-evecad 2025-12-14 papers

Issue of 2025–12–14
three papers selected by
Cliff Dominy

J Cell Mol Med. 2025 Dec;29(23): e70918

The Promise of Exosomes in Cardiac Repair: When 'Best Things Come in Small Packages'.

Anthony Yazbeck, Zena Wehbe, Yara Menassa, Alaa Abdelhamid, Assaad A Eid, Amirhossein Sahebkar, Ali H Eid.

Myocardial ischaemia continues to be a predominant global cause of mortality, leaving survivors with compromised quality of life and significant loss of functional cardiomyocytes. The main therapeutic approach, which attempts to restore heart function, generally involves myocardial reperfusion. However, this intervention is frequently complicated by the occurrence of myocardial reperfusion injury, which undermines its therapeutic benefits. Consequently, there is an increasing focus on alternative regenerative approaches, such as stem and progenitor cell therapies. Since their initial and successful use in oncology, stem cells have emerged as promising tools for mitigating various pathological conditions. Nonetheless, their efficacy in post-ischaemic myocardial environments is questioned due to their rapid degradation following delivery. Interestingly, small extracellular vesicles, particularly exosomes secreted by stem cells, demonstrate reparative properties akin to those of the stem cells themselves. Indeed, evidence strongly shows that exosomes derived from mesenchymal stem cells, cardiac progenitor cells, and induced pluripotent stem cells exert anti-apoptotic and pro-angiogenic effects in post-ischaemic cardiomyocytes while concomitantly offering protection against myocardial reperfusion injury. In this review, we critically appraise the pivotal findings supporting the potential clinical application of stem cell-derived exosomes, and underscore key considerations necessary to optimise their therapeutic efficacy.

Keywords: cardiovascular disease; myocardial infarction; myocardial ischaemia; regenerative medicine; stem cells

DOI: https://doi.org/10.1111/jcmm.70918

J Chin Med Assoc. 2025 Dec 08.

Development of extracellular vesicles in diagnostics and therapeutics: From extracellular vesicles to precision medicine.

Yuan-Jen Tsai, Yi-Hsueh Liao.

Extracellular vesicles (EVs) are membrane-bound vesicles released by various cell types and contain biologically active molecules that participate in key physiological and pathological processes. EVs play crucial roles in intercellular communication, immune regulation, tissue repair, and disease progression, particularly in cancer, neurodegenerative disorders, and cardiovascular conditions. Because of their structural stability and ability to evade immune detection, EVs are potential noninvasive biomarkers and therapeutic delivery vehicles. Advances in isolation and purification techniques have further supported their application in precision medicine, with research indicating EVs provide insight into disease mechanisms and therapeutic responses. EVs also facilitate the transfer of nucleic acids, proteins, and lipids between cells, thereby modulating gene expression and cellular activities. Their emerging role as biomarkers for diagnosis and outcome prediction, especially in cancer and neurodegenerative diseases, are areas of active investigation. Despite these promising applications, several challenges hinder clinical translation, including difficulties in distinguishing disease-derived EVs from normal EVs, the absence of standardized therapeutic protocols, the possibility of oncogenic cargo, high production costs, and variability in immune responses. Addressing these challenges by developing improved isolation techniques, standardized evaluation protocols, and cost-effective production strategies and continuing to conduct research is essential to fully realizing the diagnostic and therapeutic potential of EVs in precision medicine.

Keywords: Biomarkers; Disease Detection; Disease Progression; Extracellular Vesicles; Precision Medicine

DOI: https://doi.org/10.1097/JCMA.0000000000001326

Stem Cell Rev Rep. 2025 Dec 11.

The Potential of Neural Stem Cell-derived Exosomes for the Treatment of Ischemic Stroke.

Xu Deng, Xixiang Xie, Tao Zhu, Chunxia Chen.

Ischemic stroke is one of the leading causes of disability and mortality worldwide, posing a significant threat to human health. Neural stem cells possess the remarkable capabilities of self-renewal and differentiation into diverse neural cell types, endowing them with significant potential for the restoration of damaged neural tissues and functions. Exosomes, which carry a multitude of bioactive substances, serve as crucial tools for intercellular communication. Neural stem cell-derived exosomes are capable of engaging in the modulation of various physiological functions, presenting a highly promising novel approach for the treatment of ischemic stroke. This paper elaborates on the pathophysiological mechanisms of ischemic stroke, the engineering strategies for exosomes, and the prospects and limitations of neural stem cell transplantation therapies. It systematically reviews the potential roles of neural stem cell-derived exosomes in the treatment of ischemic stroke. Studies have shown that neural stem cell-derived exosomes can contribute to brain targeting, promote neural regeneration and angiogenesis, suppress neuroinflammation, and enhance the integrity of the blood-brain barrier in the treatment of ischemic stroke. However, their efficacy is constrained by insufficient targeting precision and limited cargo content. To improve the therapeutic efficacy of neural stem cell-derived exosomes, strategies such as surface modification and cargo loading can be employed. These include attaching targeting peptides, proteins, and antibodies to the exosome surface via chemical modification and genetic engineering, as well as loading small-molecule drugs and nanomaterials. Furthermore, accelerating the clinical translation of exosomes requires strict adherence to Good Manufacturing Practices. Neural stem cell-derived exosomes hold substantial potential in the treatment of ischemic stroke, which is expected to promote the development of the field of neural regeneration and bring new hope for more central nervous system diseases.

Keywords: Blood-brain barrier integrity; Exosomes; Ischemic stroke; Neural regeneration; Neural stem cells; Pathophysiological mechanisms

DOI: https://doi.org/10.1007/s12015-025-11036-x