Advances in Management of Spinal Cord Injury Using Stem Cell-Derived Extracellular Vesicles: A Review Study

Abstract

Introduction: Spinal cord injury (SCI) is characterized by serious both motor and sensory disability of the limbs below the injured segment. It is the most traumatic disorder among central nervous system (CNS) conditions that not only leads to psychological and physical harm to patients also results in a dramatic loss in life quality. Many efforts have been developed to find a therapeutic approach for SCI; however, an effective treatment has yet to be found. The lack of effective treatment approach and rehabilitation of SCI underscores the need to identify the novel approaches. Tissue engineering associated with stem cells has been recently introduced as an effective treatment approach for traumatic SCI. Although, low survival rates, immune rejection, cell dedifferentiation, and tumorigenicity have been addressed for tissue engneering. Regenerative medicine is an interdisciplinary field developing and applying tissue engineering, stem cell (SC) therapy, SC-derived extracellular vesicles therapy that aims to provide reliable and safe ways to replace the injured tissues and organs. The application of mesenchymal stem cells-derived extracellular vesicles (MSC-EVs) has been recently attracting attention to improve central nervous system dysfunction such as SCI, mainly through promoting neurogenesis and angiogenesis. Conclusion: This study has summarized the efficacy of MSC-EVs, including exosomes, alone or in combination with scaffolds in treatment of SCI and has then discussed the therapeutic outcomes observed in SCI experimental models following treatment with MSC-EVs alone or loaded on scaffolds in particular collagen-based scaffolds.