According to the World Health Organization, at least 2.2 billion people worldwide have near or distant vision impairment. In at least 1 billion of these cases, vision impairment could have been prevented or has yet to be addressed. Glaucoma, corneal disease, and retinal disorders are among the leading contributors to these vision impairments.
Since the pathogenesis of these eye diseases is not fully understood, fully effective treatments have yet to be developed. Considering this, Li et al. reviewed recent research to examine the effectiveness of exosomes in various diseases in vivo, which provides the potential for a new option for the treatment of eye diseases.
Exosomes are extracellular small vesicles that are formed by the regulation of endocytosis, fusion, and efflux and contain a variety of biologically active substances, including proteins, miRNAs, IncRNAs, and lipids.
Exosomes are found in all biological fluids and have roles that vary depending on their origin. These roles include cell-to-cell communication, waste transfer, and regulation of the immune system in vivo. Additionally, when serving as a carrier, exosomes are involved in many pathological processes such as nerve repair, vascular regeneration, immune response, and fibrosis formation.
Examining the various roles exosomes play within the body, the authors of this review consider their role in the treatment of serious ocular diseases, including glaucoma, diabetic retinopathy, and keratitis. Li et al. point to studies demonstrating exosomes’ ability to promote the repair of injured nerves, inhibit fibrosis, modulate immune function, and promote angiogenesis as evidence of the important role they have in treating ocular disease.
Specifically, exosomes contain a large number of immunosuppressive molecules that inhibit lymphocyte proliferation and effectively increase ocular immune tolerance to prevent ocular autoimmune disease.
Exosomes can also transfer protein and RNA to receptor cells and can accelerate wound healing of corneal epithelial cells, providing a new approach for treating large corneal lesions.
Studies have also demonstrated a link between exosomes and age-related macular degeneration (AMD) with specific exosomes considered to have neuroprotective effects that are closely related to the pathological progression of AMD.
The authors conclude that exosomes are able to be used as therapeutic carriers to participate in processes such as immune response, angiogenesis, and nerve repair in ocular-related diseases. While research into this is still emerging, the presence and accessibility of exosomes will become a potential way to diagnose and treat ocular diseases.
For the treatment of a variety of health conditions, one option more people are relying on is regenerative medicine. This field focuses on helping your body’s natural healing process function at its best, making it possible for tissues to regenerate so that you can obtain pain relief and improve mobility. There are various types of regenerative medicine. Learn more about them to know the choices you have.
Regenerative Medicine: What It Is and What It’s Used For
Regenerative medicine is a group of treatments focused on healing tissues throughout the body while also restoring the function you may have lost because of aging, medical conditions, and more.
When you’re young, your body is able to heal more efficiently, but the older you get, the longer the healing process can take. In some instances, this longer length of time even leads to the development of chronic pain issues that can be tough to deal with.
With regenerative medicine, you get the chance to try minimally invasive treatments that can offer results. Most of the best regenerative medicine options focus on stem cells, but some also rely on your blood’s components to provide lasting results.
Regenerative medicine can offer help for many types of issues, including:
The kind of condition you have may dictate the type of regenerative treatment that has the potential to be most effective.
The Different Kinds of Regenerative Medicine Therapies
There are many regenerative medicine therapies to choose from, but some of the most trusted include stem cell therapy, platelet-rich plasma, and prolotherapy.
What Is Stem Cell Therapy?
Stem cell therapy is a treatment option that utilizes stem cells to promote healing. Stem cells are undifferentiated cells that can create specialized ones. They have the ability to self-renew and create functional tissues, working as the body’s repair system.
During stem cell therapy, your healthcare provider injects stem cells into the treatment area. There are different types of stem cells, including adult stem cells and embryonic stem cells.
Adult stem cells are undifferentiated cells found in various tissues throughout the body, including fat and bone marrow. They have a more limited ability to differentiate than embryonic stem cells, but they are much more readily available because they come from your body.
Mesenchymal stem cells are found in fat and bone marrow, among other tissues, and they can help the body respond to inflammation and promote healing.
What Is Platelet-Rich Plasma?
Your blood is made up of a few components, including:
White blood cells
Red blood cells
Plasma
Platelets
Plasma is the liquid portion of blood. Platelets are not actually cells but cell fragments that help with the clotting process and contain growth factors that can stimulate cellular reproduction as well as healing at the treatment site. Platelet-rich plasma refers to plasma that has more platelets than usual.
To create a PRP injection, your doctor takes a sample of your blood and runs it through a centrifuge. The centrifuge spins the sample very rapidly, dividing the blood components so that your doctor can extract the platelets and add them to the plasma. This is then injected at the treatment area.
PRP therapy can be a good option for the treatment of ligament injuries, osteoarthritis, post-surgical healing, and even hair loss.
These injections work to reduce inflammation at the treatment site, which allows better circulation. More blood flow means the area receives more nutrients and oxygen, helping with the healing process. Less inflammation also means less pain.
What Is Prolotherapy?
Prolotherapy is another type of regenerative medicine that can be used to relieve pain. It involves injecting a small amount of an irritant, like sugar, into the treatment area. This irritant trigger an immune response and jumpstarts your body’s natural ability.
It shows promise in the treatment of musculoskeletal conditions, including issues with your bones, ligaments, soft tissues, and more.
Your body responds to the sugar or other irritant as a threat, triggering your immune and healing responses to rush to the area to remove the irritant and also begin the healing process.
Benefits of Regenerative Medicine
Regenerative medicine offers the chance to get relief from pain and inflammation without having to go through invasive procedures. Most regenerative medicine options require only a minimally invasive procedure, like providing a sample of blood or undergoing a mini liposuction procedure to obtain fat.
Because regenerative medicine procedures don’t require an elaborate process, you don’t have to worry about a long preparation or recovery period. You can usually get back to your normal life right after receiving treatment.
Regenerative medicine works to help manage the underlying cause of the pain you’re experiencing. It doesn’t just mask symptoms as pain medication and anti-inflammatories do. By offering the potential of healing injuries, it may be able to provide lasting relief.
Regenerative medicine is also more affordable than an invasive procedure like surgery. The surgery itself is costly, and the recovery can mean relying on physical therapies that add to the budget. That is not an issue you have to worry about with regenerative medicine options like stem cell therapy, PRP therapy, or prolotherapy.
Managing Pain and Inflammation with Regenerative Medicine
Regenerative medicine holds significant promise for the treatment of conditions that cause pain and inflammation. By relying on your natural healing process, regenerative medicine only improves what your body does.
If you’re considering regenerative medicine to help with any conditions you face, ask your healthcare provider about it to see if it’s a good choice for you.
Repairing the structure and functionality associated with subcutaneous cartilage defects continues to be a challenge in the fields of plastic and reconstructive surgery. While current methods, including autologous chondrocyte implantation and matrix-assisted chondrocyte implantation, have been successful in some regard, they continue to present a number of limitations, including donor limitation, donor morbidity, and degradation of the graft tissue.
Recently, cartilage progenitor cell (CPC)-based tissue engineering has drawn attention in the field of cartilage regeneration, primarily for its strong chondrogenic differentiation capacity.
Unfortunately, a general lack of a suitable chondrogenic niche has continued to hinder the clinical application of CPC-regenerated cartilage in the subcutaneous environment.
Considering this, and for the purposes of this study, Chen et al. explored the use of exosomes derived from chondrocytes (CC-Exos) as a way to provide the CPC constructs with a cartilage signal in subcutaneous environment for efficient ectopic cartilage regeneration.
After 12 weeks of post-surgical injection of CC-Exos, the authors’ animal model demonstrated that the CC-Exos injections effectively increased collagen deposition and minimized vascular ingrowth in engineered constructs, which efficiently and reproducibly developed into cartilage. This study also demonstrated that the CPC constructs supplied with these CC-Exos could also form cartilage-like tissue with minimal hypertrophy in a subcutaneous environment and with no help from any chondrogenic factors.
Additionally, Chen et al.’s study showed that CC-Exos significantly promoted chondrogenesis-related factors at the mRNA and protein levels in CPCs while also limiting angiogenesis typically associated with hypertrophic differentiation and subsequent calcification.
Despite these promising results, Chen et al. point out that the exact components associated with CC-Exos have yet to be determined. Because of this, the authors call for additional studies to determine the specific components of CC-Exos and their underlying mechanisms related to cartilage repair.
Considering the findings of this study, the authors believe that CC-Exos alone could provide a preferable chondrogenic environment, help maintain the stability of cartilage tissue, and serve as a promising therapeutic approach for the treatment of ectopic cartilage defects.
Source: Chen, Y., Xue, K., Zhang, X. et al. Exosomes derived from mature chondrocytes facilitate subcutaneous stable ectopic chondrogenesis of cartilage progenitor cells. Stem Cell Res Ther 9, 318 (2018). https://doi.org/10.1186/s13287-018-1047-2
Spinal cord injury (SCI) is a devastating pathological condition affecting motor, sensory, and autonomic function. Additionally, recovery from a traumatic SCI (TSCI) is challenging due to the central nervous system’s limited capacity to regenerate cells, myelin, and neurological connections.
While traditional therapeutic treatments have proven ineffective in assisting in recovery, mesenchymal stem cells (MSCs) hold significant promise for the treatment of TSCIs.
As part of this systematic review, Montoto-Meijide et al. analyze the efficacy, safety, and therapeutic potential of MSC-based cell therapies in TSCI.
Specifically, the authors identified 22 studies fitting the objectives of this review, which provided the information needed to analyze changes in AIS (ASIA Impairment Scale) grade; to study changes in ASIA sensory and motor score; to evaluate chances in neurophysiological and urodynamic parameters; to identify changes in neuroimaging tests; and to test for the existence of adverse effects of MSC therapy.
Typically occurring as a result of trauma related to accidents or falls, TSCIs consist of two phases, a primary and a secondary phase. Considering the progression of SCI from the primary to secondary phase, the development of a therapeutic neuroprotective approach to prevent secondary injury continues to be a priority in both clinical and basic research.
Considering this, MSCs are currently one of the most promising therapeutic options for TCI, primarily due to their capacity for neuronal differentiation and regeneration, as well as their anti-apoptotic, anti-inflammatory, and angiogenic properties.
The 22 studies analyzed as part of this review included 463 patients. When analyzed in terms of the objectives listed above, Montoto-Meijide et al. reported that in controlled studies patients who received MSC therapy improved their AIS by at least one grade, with most studies also demonstrating improvement in sensory cores and motor scores.
In terms of neuroimaging evidence, the authors reported decreased lesion cavity size and decreased lesion hyperintensity. In addition, one-third of trials reported mild or moderate adverse effects related to the route of administration, and no reported serious treatment-related adverse effects.
The authors of this review reported that their results were consistent with the findings of other recent meta-analyses conducted by other researchers and were also consistent with studies that used a large number of patients but were not included in their review.
In addition, the authors also raise several interesting points that required further study, including determining the ideal stem cell type to use, identifying the most effective route and dose of administration, and finding out which degree and stage of development of the TSCL is most receptive to MSC therapy.
While MSC therapy continues to demonstrate promising potential results, Montoto-Meijide et al. also highlight future potential therapies currently in development. These therapies include gene therapies, nanomaterials, and neurostimulation combined with rehabilitation; all three of these potential treatments have shown promise when used in patients with SCI.
Limitations of this review include the relative newness of cell therapy in TSCI made it difficult to find relative studies and most of the studies used did not have a control group, were not randomized, showed low methodological quality, and lacked detail about the process and/or patient follow-up. Considering this, the authors emphasize the need for multi-center, randomized, and controlled trials with larger numbers of patients over a long period of time as a way to draw firm conclusions regarding this therapy.
Montoto-Meijide et al. conclude the positive changes in AIS grade and in ASIA sensory and motor scores, in addition to the short- and medium-term safety of this therapy, demonstrate the potential benefit of MSC therapy in TSCI patients.
Source: Montoto-Meijide R, Meijide-Faílde R, Díaz-Prado SM, Montoto-Marqués A. Mesenchymal Stem Cell Therapy in Traumatic Spinal Cord Injury: A Systematic Review. International Journal of Molecular Sciences. 2023; 24(14):11719. https://doi.org/10.3390/ijms241411719
The Centers for Disease Control and Prevention states that an average of 795,000 people each year in the United States suffer a stroke. The majority of these are new strokes. Knowing whether you have a high risk of suffering a stroke is important, but so is knowing what you can do to lower your risk.
One important step you can take for stroke prevention is exercise. Learn more about what causes strokes and why exercise can be such an important prevention tool.
Understanding Strokes: What They Are and What Causes Them
You can think of a stroke as the equivalent of a heart attack on your brain. It is a life-threatening condition that occurs when a part of your brain doesn’t receive an adequate amount of blood. Strokes usually occur from experiencing bleeding in the brain or a blocked artery.
There are two main types of strokes: ischemic and hemorrhagic strokes. Ischemic strokes happen when cells don’t get enough blood and therefore don’t get enough oxygen. An ischemic stroke occurs if something blocks blood vessels in the brain. Blood clots can lead to ischemic strokes.
Hemorrhagic strokes lead to bleeding in or around your brain. It can occur if a blood vessel in your brain breaks open and causes bleeding that puts pressure on your brain tissue. It can also happen if you experience bleeding in the space between the brain and its outer covering.
The symptoms of a stroke vary depending on which areas of the brain it affects. You can experience one or more symptoms like:
Difficulty speaking
Blurred or double vision
One-sided weakness
Paralysis
Loss of muscle control on one side of the face
Loss of coordination
Dizziness
Vomiting
Nausea
Slurred speaking
Partial or total loss of one of the senses
Memory loss
Seizures
Headaches
The cause of the stroke can depend on the stroke type. Ischemic strokes usually occur because of blood clots, while hemorrhagic strokes happen as a result of high blood pressure, brain cancers, brain aneurysms, and more.
Some factors can put you more at risk of suffering a stroke. These are:
Obesity
Smoking
Poor diet
Physical inactivity
Diabetes
Strokes have the potential to occur at any age, but the risk rises as you grow older. If there’s a history of strokes in your family, you’re also more likely to suffer from one yourself. Drinking too much alcohol is another way to increase your chances of a stroke.
How Exercise Helps to Prevent Strokes
Exercise plays a role in reducing several stroke risk factors, including diabetes, high blood pressure, and even stress. For primary stroke prevention, high blood pressure is the most important risk factor. Physical activity helps control blood pressure because it improves vascular function.
Type 2 diabetes increases the chances of having a stroke because excessive blood glucose levels over time increase fatty deposits. These deposits narrow or block blood vessels, cutting off blood to the brain. Exercise helps improve glycemic control, so it can be an important way of managing your type 2 diabetes.
Exercise also helps promote lower cholesterol levels. Having high cholesterol levels causes plaque buildup in your arteries, including those that send blood to your brain.
For older people or those with certain medical conditions, turning to light exercise may be beneficial. Some options include gardening, taking walks, and even doing housework. The key is to avoid being inactive for long periods.
For adults who can manage moderate exercise, it’s important to engage in at least 2 ½ hours of exercise per week. You can choose activities like cycling, brisk walking, swimming, or anything else that gets your heart rate up.
Other Lifestyle Changes for Stroke Prevention
Besides adding more physical exercise to your life, you can also turn to other strategies to help prevent a stroke. For one thing, if you smoke, you should quit. Smoking significantly damages blood vessels, triggering plaque formation and even causing blood vessel breakdown. Smoking increases your blood pressure, too.
You should take a close look at your diet. Eating a diet that causes higher cholesterol levels can contribute to the development of plaque. Plaque narrows arteries and makes blood clots more likely.
Stick to lean proteins, unsaturated fats, fruits, and vegetables, and avoid sugary foods and saturated fats. You should also add fiber-rich foods to your diet. It is also important to cut down on the amount of alcohol you drink. Alcohol increases your blood pressure, making blood clots more likely to happen. Blood clots can cut off your blood supply and lead to strokes.
Another important step you can take if you want to prevent a stroke is to incorporate stress management techniques into your day. Stress makes the heart work harder, which increases blood pressure.
At the same time, sugar and fat levels in the blood also increase when you experience stress. They impact arterial health as well. All these factors may lead to the development of clots. Finding ways of managing stress goes a long way toward addressing these issues.
You can opt for doing deep breathing exercises, as well as focusing on mindfulness strategies to help you stay in the present. Some people benefit from meditation or yoga, while others do better if they take time to exercise. Taking up relaxing hobbies is another excellent option.
Regenerative Medicine: Can It Help with Strokes?
Working to prevent strokes is important, and your strategies for doing so can be as simple as adjusting your diet and adding exercise to your daily routine. If you’ve already experienced a stroke, however, you can also use these strategies to prevent future ones. Lowering your blood pressure, managing your diabetes, and lowering stress levels can all help.
If a previous stroke has left you with symptoms that affect your life, a treatment option that shows promise is stem cell therapy. Stem cell therapy encourages your body to heal using its natural processes, allowing you the chance to regain some of your brain’s lost function. Ask your doctor about regenerative medicine options like stem cell therapy.
Osteoarthritis (OA) is a chronic joint condition that causes pain and lack of mobility through the progressive degradation of joint cartilage. While there are several current pharmaceutical, physical therapy, and surgical treatments to address the symptoms of OA, researchers are interested in developing new therapeutic treatment approaches to address the relentless progression of the condition.
Considering their documented biocompatibility, immunomodulatory properties, and ability to precisely target specific cells and tissues, exosomes have recently emerged as a promising therapeutic option as a drug delivery system (DDS) for the treatment of OA. Specifically, these exosome-based strategies have demonstrated a safe and effective way to enhance cartilage repair, mitigate inflammation, and alleviate the persistent pain associated with OA.
While the benefits of exosome-based DDSs have been demonstrated in numerous studies, according to the author of this review, the specific application of this option for the purpose of treating OA has not been sufficiently explored.
In this review, Lu et al. summarize the emerging developments surrounding exosome-based DDSs of OA and highlight the present challenges associated with this evolving therapeutic option.
Recent studies have demonstrated the benefit of using exosomes for the delivery of drugs designed to treat OA. Specifically, researchers have found that exosomes derived from mesenchymal stem cells (MSCs) are able to be effective carriers for the delivery of specific molecules that lead to the promotion of chondrogenesis and improvement in cartilage regeneration. These same exosomes have also demonstrated themselves to be effective carriers for the localized delivery of anti-inflammatory drugs known for their potent anti-inflammatory and immunosuppressive effects.
Other studies show the potential of exosomes as an effective way to deliver growth factors to the affected joint in a targeted and sustained manner. The same exosomes have also demonstrated promise as a platform for gene delivery to areas affected by OA; a few of the notable advantages include the ability to safeguard genetic material from degradation and enable targeted delivery to specific cells and tissues.
While there is seemingly unlimited potential for using exosomes as DDSs in OA treatment, Lu et al. also call attention to several technical challenges and limitations that need to be addressed in order to fully maximize their potential and to ensure their safe application. These challenges and limitations include figuring out how to obtain a consistent supply of high-quality exosomes, developing effective methods that allows for efficient loading and controlled release of therapeutic molecules within exosomes, and a current lack of comprehensive long-term data regarding the safety and biocompatibility of exosome-based therapies.
Despite these challenges and limitations, the authors conclude that exosomes have emerged as highly promising candidates for drug delivery in OA therapy and offer numerous advantages over conventional delivery systems.
Source: Jun Lu, Yan Zhang, Xinquan Yang, Hongmou Zhao, Harnessing exosomes as cutting-edge drug delivery systems for revolutionary osteoarthritis therapy, Biomedicine & Pharmacotherapy, Volume 165,2023,115135, ISSN 0753-3322, https://doi.org/10.1016/j.biopha.2023.115135.
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