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Table 1 Studies on the treatment of SCI with exosomes derived from MSCs

From: Mesenchymal stem cell-derived exosomes: therapeutic opportunities and challenges for spinal cord injury

Study Type of MSC Animal Exosome diameter Administration Biological effects Mechanisms of actions
Huang et al. [65] Epidural Fat-MSCs SD rats 60–130 nm Intravenous injection (IV) Alleviate cell death, attenuate tissue damage, and improve neurological recovery Inhibit NLRP3 inflammation
Pasquale et al. [66] hUCMSCs SD rats IV anti-inflammatory and anti-scarring activity Decrease the expression of pro-inflammatory cytokines and reduce astrogliosis and scarring.
Huang et al. [67] BMSCs SD rats 20–130 nm IV Attenuate cellular apoptosis and inflammation. Promote angiogenesis Attenuate Bax expression and upregulate Bcl-2 expression. Upregulate pro-inflammatory cytokines and downregulate anti-inflammatory cytokines.
Lu et al. [68] BMSCs SD rats IV Attenuate neuronal cell death and Improve motor recovery Increases BSCB pericyte coverage and decreases BSCB permeability. Inhibit pericyte migration via the NF-κB p65 pathway.
Liu et al. [69] BMSCs SD rats 20–150 nm IV Attenuate neuronal cell apoptosis and lesion size. Suppressed glial scar formation and inflammation. Promote axonal regeneration. Suppress the activation of A1 neurotoxic reactive astrocytes. Reduce TNF-α, IL-1β, and IL-6.
Wang et al. [70] BMSCs SD rats 30–150 nm IV Reduce SCI-induced A1 astrocytes Inhibit the nuclear translocation of NF-κB p65.
Yu et al. [71] BMSCs SD rats IV Accelerate the motor function and promote neuronal regeneration. Alleviate histopathological damage. MiR-29b regulate proteins involved in neuronal regeneration, such as NF200, GAP-43, and GFAP.
Zhou et al. [72] BMSCs Wistar rats 40–160 nm IV Improve functional recovery and attenuate lesion size and apoptosis MiR-21-5p downregulate expression of the pro-apoptotic target gene FasL.
Ji et al. [73] BMSCs SD rats 30–100 nm IV Attenuate the protective effects of obese rat MSC-derived exosomes against SCI Insulin resistance decreased miR-21 expression in MSCs. Overexpression of miR-21 in obese rat MSCs restored the protective effects.
Xu et al. [74] hMSCs PC12 cells SD rats IV Suppresses the apoptosis of neuron cells and improve functional recovery MiR-21 and miR-19b derived from the exosomes of hMSCs regulated the apoptosis and differentiation of neuron cells by regulating PTEN expression
Kang et al. [75] SD rats 40–110 nm IV MiR-21 facilitate post-SCI recovery and suppress neuron cell death MiR-21 inhibit the expression of PTEN/PDCD4. MiR-21/PTEN/PDCD4 signaling pathways increased cell viability and inhibited cell death in vitro
Sun et al. [76] hUCMSCs C57BL/6 mice 70 nm IV Promote locomotor functional recovery and reduce inflammation Downregulate the inflammatory cytokines, such as TNF-α, MIP-1α, IL-6 and IFN-γ and trigger the macrophage Polarization from M1 to M2 phenotype
Li et al. [77] BMSCs SD rats IV Improved functional recovery, Reduced the lesion volume, Preserved neurons. MiR-133b activate ERK1/2, STAT3, and CREB. Inhibit RhoA expression.
Li et al. [78] BMSCs Wistar rats Improve locomotor functional recovery and inhibit neuronal apoptosis. Activate the Wnt/β-catenin signaling pathway.
Zhao et al. [79] BMSCs Wistar rats 20–130 nm IV Improve functional recovery and reduce SCI-Induced complement activation. Inhibit complement mRNA synthesis and release and inhibit activation of NF-κB signaling by binding to microglia cells.
Huang et al. [80] BMSCs SD rats 30–120 nm IV Improved functional recovery and reduced the lesion volume. Promote angiogenesis and neurogenesis.
Yuan et al .[81] BMSCs SD rats IV Improved functional recovery and the axonal regeneration. Decreased the injury volume, retained the neuronal cells, MiR-126 activates ERK1/2, STAT3 and CREB while inhibiting the expression of RhoA.
Gu et al. [82] BMSCs SD rats 30–150 nm IV Improve the recovery of motor function. Reduce neuronal apoptosis. The expression of proapoptotic protein caspase-3 is decreased while the antiapoptotic protein Bcl-2 is upregulated, BMSC-exosomes induces activation of autophagy after SCI.