Role of Exosomes as a Treatment and Potential Biomarker for Stroke
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REVIEW ARTICLE
Role of Exosomes as a Treatment and Potential Biomarker for Stroke Laura Otero-Ortega 1 & Fernando Laso-García 1 & MariCarmen Gómez-de Frutos 1 & Blanca Fuentes 1 & Luke Diekhorst 1 & Exuperio Díez-Tejedor 1 & María Gutiérrez-Fernández 1 Received: 23 May 2018 / Revised: 16 July 2018 / Accepted: 6 August 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Approximately, 16 million strokes occur worldwide each year, causing 6 million deaths and considerable disability, implying an enormous social, individual health, and economic burden. Due to this high incidence, strategies to promote stroke recovery are urgently needed. Research into new therapeutic approaches for stroke has determined that intravenous administration of mesenchymal stem cells (MSCs) is a good strategy to improve recovery by amplifying mechanisms implicated in brain plasticity. Recent studies have demonstrated the efficacy of MSCs in stroke, with no need for them to reach the area of brain injury. Although the mechanisms by which they mediate restorative effects are still unknown, the evidence suggests that MSCs might use specialised communication by sending and receiving biological information included in elements called exosomes. Exosomes are nanosized extracellular vesicles released into physical environments, and they have recently been suggested to mediate restorative stem cell effects. Moreover, after stroke, exosomes can also be synthesised and released from brain cells, passing through the blood-brain barrier (BBB), and can be detected in peripheral blood or in cerebrospinal fluid. Thus, exosomes could possibly be biomarkers that reflect pathological progress and promote stroke recovery. This review discusses the translational aspects of MSC-derived exosomes and their various roles in brain repair and as circulating biomarkers in stroke. Keywords Brain repair . Exosomes . Mesenchymal stem cells . Neurological disease . Therapeutic strategy
Introduction According to the World Health Organization, stroke is the leading cause of death and disability worldwide [1]. Approximately, 6 million people die due to stroke each year; 80% of these deaths occur in low- and middleincome countries. Pathophysiological responses after stroke are complex, and there is currently no therapy to repair the damage after stroke [1]. Specifically, for ischaemic stroke, only intravenous thrombolysis (tissue plasminogen activator), endovascular treatment, and their management in a stroke unit are effective therapies to treat the injury [2]. In the case of intracerebral haemorrhage, specific treatment approaches, including early diagnosis and
* María Gutiérrez-Fernández [email protected] 1
Neuroscience and Cerebrovascular Research Laboratory, Department of Neurology and Stroke Centre, La Paz University Hospital, Neuroscience Area of IdiPAZ Health Research Institute, Autonomous University of Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain
haemostasis, management of blood pressure, and minimally
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