Cardiovascular diseases continue to be the leading cause of death globally, accounting for nearly 18 million deaths each year with heart attack and stroke accounting for 80% of deaths.

Recently, stem-cell-based therapy has demonstrated the potential to regenerate damaged myocardium and to treat a wide range of cardiovascular diseases (CVDs). Specifically, the ability of mesenchymal stem cells (MSCs) to differentiate into cardiomyocytes, endothelial cells, and vascular smooth muscle cells has created a potentially new and promising therapeutic approach for the treatment of CVDs.

Huang et al. summarize the recent advances in MSC therapy, including the role of exosomes in future treatments of CVDs. 

Recent studies have demonstrated that MSCs were able to secret cholesterol-rich, phospholipid exomes that were enriched with microRNAs (miRNAs). These exomes are nano-sized particles originating from multivesicular endosomal ranging in size from 30 – 100 nm and contain cytokines, proteins, lipids, mRNAs, and miRNAs. These exosomes are suggested as central mediators of intercellular communication and transfer proteins, mRNAs and miRNAs to adjacent cells.  

The miRNAs found in exosomes play an essential role in various physiological and pathological processes by regulating gene expression at the post-transcription level. When applied in the cardiovascular system, miRNAs are internalized into CMCs and ECs and result in cardiomyocyte protection and angiogenesis promotion that has demonstrated beneficial and anti-inflammatory effects including cardiac regeneration, neovascularization, and anti-vascular remodeling; these observed benefits include improved cardiac function after a myocardial infarction (MI), reduced inflammation related to pulmonary hypertension, and increased tissue healing following an ischemia-reperfusion injury.

Huang et al. conclude that the studies evaluated in this review provide evidence that MSC-derived exosomes play an essential role in MSC-based therapy of CVDs including MI, reperfusion injury, and PH. Considering these conclusions, the authors call for additional studies to determine the detailed mechanisms and underlying benefits to determine their exact role. 

Source: “Exosomes in Mesenchymal Stem Cells, a New Therapeutic Strategy ….” 12 Jan. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308409/.

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