Affiliation:
1. Department of Anesthesiology West China Hospital Sichuan University Laboratory of Anesthesia and Critical Care Medicine National‐Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology West China Hospital Sichuan University Chengdu Sichuan 610041 China
2. Department of Cardiology, Honghui hospital Xi'an Jiaotong University Xi'an 710049 China
3. Diseases and Hormones of the Nervous System University of Paris‐Scalay Bicêtre Hosptial Bât Grégory Pincus 80 Rue du Gal Leclerc, Cedex Le Kremlin Bicêtre 94276 France
4. Department of Neurology Institute of Cell Engineering School of Medicine Johns Hopkins University Baltimore MD 21218 USA
Abstract
AbstractAcknowledging the neurological symptoms of COVID‐19 and the long‐lasting neurological damage even after the epidemic ends are common, necessitating ongoing vigilance. Initial investigations suggest that extracellular vesicles (EVs), which assist in the evasion of the host's immune response and achieve immune evasion in SARS‐CoV‐2 systemic spreading, contribute to the virus's attack on the central nervous system (CNS). The pro‐inflammatory, pro‐coagulant, and immunomodulatory properties of EVs contents may directly drive neuroinflammation and cerebral thrombosis in COVID‐19. Additionally, EVs have attracted attention as potential candidates for targeted therapy in COVID‐19 due to their innate homing properties, low immunogenicity, and ability to cross the blood‐brain barrier (BBB) freely. Mesenchymal stromal/stem cell (MSCs) secreted EVs are widely applied and evaluated in patients with COVID‐19 for their therapeutic effect, considering the limited antiviral treatment. This review summarizes the involvement of EVs in COVID‐19 neuropathology as carriers of SARS‐CoV‐2 or other pathogenic contents, as predictors of COVID‐19 neuropathology by transporting brain‐derived substances, and as therapeutic agents by delivering biotherapeutic substances or drugs. Understanding the diverse roles of EVs in the neuropathological aspects of COVID‐19 provides a comprehensive framework for developing, treating, and preventing central neuropathology and the severe consequences associated with the disease.
Funder
National Natural Science Foundation of China
Subject
General Physics and Astronomy,General Engineering,Biochemistry, Genetics and Molecular Biology (miscellaneous),General Materials Science,General Chemical Engineering,Medicine (miscellaneous)