Extracellular vesicles for treatment of solid organ ischemia-reperfusion injury

Am J Transplant. 2020 Dec;20(12):3294-3307. doi: 10.1111/ajt.16164. Epub 2020 Jul 28.

Abstract

As the incidence of ischemia-reperfusion (I-R) injury has substantially increased, there is a pressing need to develop effective strategies to treat this global health issue. I-R injury can affect all organs and is associated with high morbidity and mortality rates. Pathological settings such as myocardial infarction, stroke, hemorrhagic shock, and solid organ transplant are particularly prone to cause I-R injury. Ischemia (hypoxia) and/or reperfusion (reoxygenation) induces various forms of cellular and structural damage. A major cause of damage is local inflammatory responses, which may spread to produce more advanced systemic inflammation. Management of I-R injury relies primarily on supportive measures, as specific treatment strategies are lacking. Extracellular vesicles (EVs) are cell-secreted nano-scale structures containing various biomolecules involved in cell communication and multiple physiological processes. EVs derived from certain cell types have been shown to exhibit anti-inflammatory, antioxidant, and angiogenic properties. This review provides an overview of EV-based therapeutics for I-R injury in kidneys, liver, heart, lungs, and brain. Additionally, the mechanisms by which EVs protect against I-R injury are discussed. Promising preclinical findings highlight the potential clinical use of EVs for I-R injury.

Keywords: animal models; basic (laboratory) research / science; heart transplantation / cardiology; ischemia reperfusion injury (IRI); kidney transplantation / nephrology; liver transplantation / hepatology; tissue injury and repair; translational research / science.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Kidney Injury*
  • Extracellular Vesicles*
  • Humans
  • Kidney
  • Mesenchymal Stem Cells*
  • Reperfusion Injury*