神经退行性疾病治疗的进展:干细胞临床试验和工程外泌体的前景

IF 5 1区 医学 Q1 NEUROSCIENCES
Sevim Isik, Sajeda Osman, Bercem Yeman-Kiyak, Suhair Rami Mohammed Shamshir, Nesrin Majdi Edwan Sanchez
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引用次数: 0

摘要

本综述系统评价了94项干细胞治疗神经退行性疾病的临床试验,包括阿尔茨海默病、帕金森病、肌萎缩侧索硬化症和亨廷顿病。方法使用相关检索词收集数据,专注于干细胞治疗。在这些试验的8000多名参与者中,近70%的人参加了与ad相关的研究。仅进行了3项3期研究,大多数试验都处于早期阶段(1期和2期)。间充质干细胞、神经干细胞、诱导多能干细胞和胚胎干细胞是治疗神经退行性疾病最常用的细胞。本综述还探讨了基于干细胞衍生的外泌体治疗神经退行性疾病的临床前和临床研究的新兴领域。结果外泌体可以穿过血脑屏障,将治疗分子直接输送到大脑,为干细胞移植提供了一种侵入性较小的替代方案。特别是间充质干细胞衍生的外泌体,通过减少神经炎症、氧化应激和促进神经元再生,在临床前模型中显示出显著的潜力。此外,外泌体工程的最新进展,包括表面修饰、治疗剂装载和转基因修饰,已经改善了靶向性、稳定性、血脑屏障传递和神经细胞相互作用,使靶向和有效的治疗成为可能。基于外泌体的治疗方法尚处于临床研究的初步阶段,目前仅有3项临床试验。结论随着人们对外泌体治疗的兴趣日益浓厚,临床研究有望增加。这种增长将受到外泌体技术的持续进步、对其治疗潜力的更深入了解以及对神经退行性疾病创新治疗策略不断增长的需求的推动。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Advances in Neurodegenerative Disease Therapy: Stem Cell Clinical Trials and Promise of Engineered Exosomes

Advances in Neurodegenerative Disease Therapy: Stem Cell Clinical Trials and Promise of Engineered Exosomes

Aim

This review provides a systematic evaluation of 94 stem cell clinical trials to treat neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease.

Methods

Data were collected from using relevant search terms, focusing exclusively on stem cell therapy. Of the 8000+ participants in these trials, nearly 70% were enrolled in AD-related studies. Only three Phase 3 studies were conducted, and most trials were in the early phases (Phases 1 and 2). Mesenchymal stem cells, neural stem cells, induced pluripotent stem cells, and embryonic stem cells are used the most to treat neurodegenerative diseases. This review also explores the emerging fields of preclinical and clinical investigations of stem cell-derived exosome-based therapies for neurodegenerative diseases.

Results

Exosomes can cross the blood–brain barrier to deliver therapeutic molecules directly to the brain, offering a less invasive alternative to stem cell transplantation. Mesenchymal stem cell-derived exosomes, in particular, have demonstrated significant potential in preclinical models by reducing neuroinflammation, oxidative stress, and promoting neuronal regeneration. Additionally, recent advances in exosome engineering, including surface modifications, therapeutic agent loading, and transgenic modifications, have improved targeting, stability, blood–brain barrier delivery, and neural cell interactions, enabling targeted and effective treatment. Exosome-based therapies are in the preliminary phases of clinical investigation, with only three clinical trials.

Conclusion

Given the increasing interest in exosome therapy, clinical investigations are expected to increase. This growth will be driven by ongoing advancements in exosome technology, a deeper understanding of their therapeutic potential, and escalating demand for innovative treatment strategies for neurodegenerative diseases.

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来源期刊
CNS Neuroscience & Therapeutics
CNS Neuroscience & Therapeutics 医学-神经科学
CiteScore
7.30
自引率
12.70%
发文量
240
审稿时长
2 months
期刊介绍: CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.
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