Stem cell exosomes in the pathophysiology of cardiovascular diseases

Abstract

This study focused on the current state of the therapeutic potential of extracellular vesicles, which depends on the methods of their isolation and composition and the characteristics of the vesicular and nonvesicular components. Myocardial damage, particularly as a result of acute myocardial infarction, leads to irreversible death of cardiomyocytes and sarcomeres and ultimately to heart failure. The adult heart has limited regenerative capacity; therefore, stimulation of endogenous repair and regenerative potentials using cell therapy has potential. Moreover, the benefit from the injection of stem cells and progenitor cells into the damaged myocardium is mediated by the factors they secrete. In particular, exosomes, nanosized secreted extracellular vesicles of endosomal origin, have become key signaling organelles in intercellular communication and are currently considered key regenerative components of the secretome of stem and progenitor cells. Exosomes released from cardiac embryonic and mesenchymal stem cells, resident stem and progenitor cells (including a specific subgroup of cardiosphere cells), induced pluripotent stem cells, and cardiomyocytes isolated from these cells have cardioprotective, immunomodulatory, and reparative abilities. The use of exosomes in the targeted transport of drugs in lipid-like nanocontainers and extracellular vesicles is another promising area. Because artificial drug carriers, including liposomes and lipid-based nanoparticles, are limited by potential toxicity, immunogenicity, and inability to target specific organs, exosomes hold good promise as potential drug carriers. Compounds can be transported both inside exosomes and on their surface. Secreted extracellular vesicles, particularly exosomes, can be considered a key functional component of the secretome of stem cells and cardiogenic progenitor cells (mesenchymal stem cells, endogenous cardiac progenitor cells, cardiospheres, bone marrow embryonic stem cells, and bone marrow induced pluripotent stem cells). They have demonstrated therapeutic efficacy in preclinical models in the study of cardiovascular pathology.