间充质干细胞源性外泌体抑制创伤性脑损伤炎症反应的研究进展

Research progress of the roles of mesenchymal stem cells-derived exosomes in inhibiting the inflammatory response in traumatic brain injury

摘要:

中国每年约有80万新发创伤性脑损伤（TBI）患者，其中重度患者死亡率约为27%，是青壮年死亡和致残的首要原因，为社会及家庭带来极大影响。TBI按病理、生理机制分为原发性脑损伤和继发性脑损伤。原发性脑损伤是机械性致伤因素的直接结果，而继发性脑损伤是在原有脑损伤基础上，颅外损伤与颅内物理、生化变化的总和，与TBI预后有重要关系。其中神经炎症反应所引起的一系列分子、细胞、组织器官水平级联反应在继发性脑损伤形成中有重要作用。目前间充质干细胞源性外泌体（MSC-Exo）作为脑损伤极具前景的治疗方式，可有效减轻神经炎症反应，改善TBI预后。该文就MSC-Exo抑制TBI后神经炎症反应的作用机制及其治疗前景作一综述，以期为后续的研究和治疗提供一定的参考。

Abstract:

There are about 800,000 patients suffering from traumatic brain injury (TBI) in China each year. The mortality of patients with severe TBI is about 27%. TBI is the leading cause of death and disability among young adults and has a great impact on society and families. According to the pathophysiology, TBI is divided into primary brain injury and secondary brain injury. Primary brain injury is a direct result of mechanical factors, while secondary brain injury is based on the original brain injury. Both the extracranial injury and intracranial physical and biochemical changes are tightly associated with the prognosis of TBI, among which a series of cascade reactions at the levels of molecules, cells, tissues and organs caused by neuroinflammatory responses play a particularly important role in the development of secondary brain injury. The mesenchymal stem cells-derived exosomes (MSC-Exo) are a promising strategy for treating brain injury. They can effectively reduce the neuroinflammatory response and improve the prognosis of TBI. This review summarizes the mechanisms of MSC-Exo inhibiting the neuroinflammatory response after TBI and their therapeutic potentials, in order to provide a reference for future research and treatment.