Exosomes: Cell-Free Therapy for Cardiovascular Diseases
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REVIEW
Exosomes: Cell-Free Therapy for Cardiovascular Diseases Nana He 1,2,3 & Yuelin Zhang 4 & Shun Zhang 2,3 & Dongjuan Wang 1 & Honghua Ye 1 Received: 7 November 2019 / Accepted: 4 February 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Cardiovascular diseases (CVDs) are an important cause of death and disease worldwide. Because injured cardiac tissue cannot be repaired itself, it is urgent to develop other alternate therapies. Stem cells can be differentiated into cardiomyocytes, endothelial cells, and vascular smooth muscle cells for the treatment of CVDs. Therefore, cell therapy has recently been considered a viable treatment option that can significantly improve cardiac function. Nonetheless, implanted stem cells rarely survive in the recipient heart, suggesting that the benefits of stem cell therapy may involve other mechanisms. Exosomes derived from stem cells have a myocardial protection function after myocardial injury, and may be a promising and effective therapy for CVDs. Here, we discuss the application and mechanism of exosomes derived from stem cells in the diagnosis and treatment of CVDs and provide evidence for the application of exosomes in CVDs.
Keywords Exosomes . Stem cells . Cardiovascular diseases
Introduction
Abbreviations AMI CVDs CPCs ESCs EVs HUVECs iPSCs MSCs miRNAs, miRs mRNAs lncRNAs
Acute myocardial infarction Cardiovascular diseases Cardiac progenitor cells Embryonic stem cells Extracellular vesicles Human umbilical vein endothelial cells Induced pluripotent stem cells Mesenchymal stem cell MicroRNAs Messenger RNAs Long noncoding RNAs
Associate Editor Junjie Xiao oversaw the review of this article * Honghua Ye [email protected] 1
Department of Cardiology, HwaMei Hospital (previously named Ningbo No. 2 Hospital), University of Chinese Academy of Sciences, 41 Xibei Street, Ningbo 315010, Zhejiang, China
2
Department of Experimental Medical Science, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China
3
Key Laboratory of Diagnosis and Treatment of Digestive System Tumors of Zhejiang Province, Ningbo, China
4
Department of Medicine, University of Ningbo, Ningbo, China
Despite significant advances in the medical treatment of cardiovascular diseases (CVDs), such as drug pretreatment, interventional therapy, and surgery, inducing cardiomyocyte differentiation and proliferation remains difficult. In fact, the inability of infarcted and nonfunctional cardiomyocytes to function normally is a major problem in the treatment of CVDs. Therefore, it is necessary to develop new treatments, such as cell-based therapies, for CVDs. Cell therapy is now regarded as one of the most promising approaches for treating CVDs [1, 2]. A number of animal studies confirmed the curative utility of stem cells in CVDs, including mesenchymal stem cell (MSCs) [3], embryonic stem cells (ESCs) [4], and induced pluripotent stem cells (iPSCs) [5]. Clinical trials have demonstrated that some stem cell-based therapies have a therapeutic effect on CV
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