Cerebrolysin-loaded platelet-rich plasma exosomes: Restoring immune homeostasis via TNF-α/IL-10 modulation and apoptosis targeting for spinal cord injury repair.

Context/objective: Spinal cord injury (SCI) is a severe condition characterized by neuronal apoptosis and inflammation, with limited therapeutic options. This study aimed to assess the effects of platelet-rich plasma (PRP)-derived exosomes (Exo), Cerebrolysin (CBL), and Cerebrolysin-loaded exosomes (CLE) on inflammation, apoptosis, tissue organization, and motor function recovery in a mouse model of compression SCI.

Design: An experimental study using a mouse model of SCI, investigating the effects of Exo, CBL, and CLE treatments.

Setting: Laboratory-based research in a controlled environment.

Participants: Sixty healthy adult female BALB/c mice, aged 8-10 weeks, weighing 24 ± 2 g were used. SCI was induced via compression to model SCI.

Interventions: Mice with induced SCI were treated with Exo, CBL, or CLE. Apoptosis was assessed by Bax and Bcl2 expression. Inflammatory markers TNF-α and IL-10 were measured. Histological analysis examined tissue organization, and motor function recovery was evaluated using the Basso-Beattie-Bresnahan (BBB) locomotor scale.

Outcome measures: The study measured Bax and Bcl2 expression, TNF-α and IL-10 levels, tissue organization, and motor function recovery.

Results: CLE treatment significantly modulated Bax and Bcl2 expression, reducing apoptosis and enhancing neuronal survival. TNF-α levels decreased, indicating reduced inflammation, while IL-10 levels increased, showing anti-inflammatory effects. Histological assessment revealed improved tissue organization, and motor function recovery was significantly enhanced as measured by BBB scores.

Conclusion: CLE showed neuroprotective and anti-inflammatory effects, reducing apoptosis and inflammation while promoting tissue repair and motor function recovery in SCI, making it a promising therapeutic candidate.