Extracellular vesicles as standard-of-care therapy: will fast-tracking the regulatory processes help achieve the goal?

IF 2.4 4区 医学 Q4 CELL & TISSUE ENGINEERING
Vaijayanti Kale
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Abstract

Extracellular Vesicles (EVs) became a focus of clinical research when experimental and pre-clinical studies showed that they mimic their parent cells' regenerative and therapeutic effects and their cargo carries disease-specific diagnostic and prognostic biomarkers. Since the publication of data forms an endpoint of the study, this review specifically focused on the published clinical trials done with EVs. For brevity, this review was restricted to the last 10 years. Unexpectedly, the literature search showed that very few clinical trials assessing the therapeutic applications of EVs were published in this period indicating that they have not reached their desired endpoint. Conversely, most studies showed the potential of EVs present in various biofluids as a promising source of diagnostic and prognostic biomarkers for various diseases, and predictive markers to assess the effectiveness of therapy. This stark difference in the numbers could perhaps be due to the time-consuming regulatory processes involved in the clinical-grade preparation and characterization of EVs, and the determination of their safety and effective dose regimens. One wonders whether fast-tracking regulatory affairs could help accelerate the therapeutic use of EVs. This aspect needs urgent attention.

细胞外囊泡作为标准疗法:加快监管进程是否有助于实现目标?
实验和临床前研究表明,细胞外囊泡(EVs)能模拟母细胞的再生和治疗效果,而且其载体携带有疾病特异性诊断和预后生物标志物,因此成为临床研究的焦点。由于数据的发表是研究的终点,因此本综述特别关注已发表的使用 EVs 进行的临床试验。为简洁起见,本综述仅限于过去 10 年的研究。意想不到的是,文献检索结果显示,在此期间发表的评估 EVs 治疗应用的临床试验非常少,这表明这些试验尚未达到预期终点。相反,大多数研究表明,存在于各种生物流体中的 EVs 有潜力成为各种疾病的诊断和预后生物标志物,以及评估治疗效果的预测标志物。数量上的巨大差异可能是由于临床级制备和表征 EVs 以及确定其安全性和有效剂量方案所涉及的监管流程耗时较长。我们不禁要问,快速处理监管事务是否有助于加快 EVs 的治疗应用。这方面亟需关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Regenerative medicine
Regenerative medicine 医学-工程:生物医学
CiteScore
4.20
自引率
3.70%
发文量
82
审稿时长
6-12 weeks
期刊介绍: Regenerative medicine replaces or regenerates human cells, tissue or organs, to restore or establish normal function*. Since 2006, Regenerative Medicine has been at the forefront of publishing the very best papers and reviews covering the entire regenerative medicine sector. The journal focusses on the entire spectrum of approaches to regenerative medicine, including small molecule drugs, biologics, biomaterials and tissue engineering, and cell and gene therapies – it’s all about regeneration and not a specific platform technology. The journal’s scope encompasses all aspects of the sector ranging from discovery research, through to clinical development, through to commercialization. Regenerative Medicine uniquely supports this important area of biomedical science and healthcare by providing a peer-reviewed journal totally committed to publishing the very best regenerative medicine research, clinical translation and commercialization. Regenerative Medicine provides a specialist forum to address the important challenges and advances in regenerative medicine, delivering this essential information in concise, clear and attractive article formats – vital to a rapidly growing, multidisciplinary and increasingly time-constrained community. Despite substantial developments in our knowledge and understanding of regeneration, the field is still in its infancy. However, progress is accelerating. The next few decades will see the discovery and development of transformative therapies for patients, and in some cases, even cures. Regenerative Medicine will continue to provide a critical overview of these advances as they progress, undergo clinical trials, and eventually become mainstream medicine.
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