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Therapeutic Effects of Mesenchymal Stromal Cell-Derived Small Extracellular Vesicles in Oxygen-Induced Multi-Organ
Angeles Fernandez-Gonzalez1,2, Gareth R Willis1,2, Vincent Yeung1,2
1Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, United States.
Insights
Mesenchymal stem/stromal cell-derived extracellular vesicles (MEx) offer a promising, unified treatment for preterm infant morbidities. These vesicles promote anti-inflammatory and regenerative processes, addressing multisystemic lesions from early-life physiological disruption.
Area of Science:
- Neonatal Medicine
- Regenerative Medicine
- Developmental Biology
Background:
- Extremely low birth weight infants face lifelong chronic illnesses, including pulmonary, retinal, and neurocognitive morbidities, despite advances in neonatal care.
- Preterm birth-related pathologies often stem from common triggers like oxygen fluctuations and inflammation, necessitating unified therapeutic strategies.
- Current interventions struggle to address the multisystemic nature of these conditions effectively.
Purpose of the Study:
- To discuss pathogenic mechanisms underlying multisystemic lesions in preterm infants.
- To introduce mesenchymal stem/stromal cell-derived extracellular vesicles (MEx) as a potential unitary treatment.
- To highlight MEx's role in immunomodulation, homeostasis, and tissue regeneration for multisystem therapy.
Main Methods:
- Review of pre-clinical studies on MEx mechanisms of action in preterm birth-related pathologies.
- Analysis of pathogenic pathways triggered by high oxygen exposure and inflammation in early life.
- Discussion of MEx as immunomodulators and growth-promoting mediators.
Main Results:
- Mesenchymal stem/stromal cell-derived extracellular vesicles (MEx) exhibit inherent anti-inflammatory, pro-angiogenic, and trophic activities.
- MEx have demonstrated potential in immunomodulation, homeostasis, and tissue regeneration.
- Pre-clinical research is exploring MEx's restorative capabilities for preterm pathologies, with a growing focus on multisystemic effects.
Conclusions:
- MEx represent a promising therapeutic candidate for addressing the multisystemic morbidities associated with preterm birth.
- Targeting common triggers like oxygen fluctuations and inflammation with MEx could provide a unified treatment approach.
- Further research into MEx's multisystemic therapeutic potential is warranted for improving outcomes in extremely low birth weight infants.
Abstract:
Despite major advances in neonatal intensive care, infants born at extremely low birth weight still face an increased risk for chronic illness that may persist into adulthood. Pulmonary, retinal, and neurocognitive morbidities associated with preterm birth remain widespread despite interventions designed to minimize organ dysfunction. The design of therapeutic applications for preterm pathologies sharing common underlying triggers, such as fluctuations in oxygen supply or in the inflammatory state, requires alternative strategies that promote anti-inflammatory, pro-angiogenic, and trophic activities-ideally as a unitary treatment. Mesenchymal stem/stromal cell-derived extracellular vesicles (MEx) possess such inherent advantages, and they represent a most promising treatment candidate, as they have been shown to contribute to immunomodulation, homeostasis, and tissue regeneration. Current pre-clinical studies into the MEx mechanism of action are focusing on their restorative capability in the context of preterm birth-related pathologies, albeit not always with a multisystemic focus. This perspective will discuss the pathogenic mechanisms underlying the multisystemic lesions resulting from early-life disruption of normal physiology triggered by high oxygen exposures and pro-inflammatory conditions and introduce the application of MEx as immunomodulators and growth-promoting mediators for multisystem therapy.
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