Mesenchymal Stromal/Stem Cell Extracellular Vesicles and Perinatal Injury: One Formula for Many Diseases

Area of Science:

• Neonatology
• Regenerative Medicine
• Cell Biology

Background:

• Advances in neonatal care improve survival of extremely premature infants, but significant morbidity persists.
• Common neonatal morbidities include bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), hypoxic ischemic encephalopathy (HIE), and retinopathy of prematurity (ROP).
• Shared immune and inflammatory pathways in these conditions suggest potential for multisystem therapeutic interventions.

Approach:

• Mesenchymal stem/stromal cells (MSCs) have demonstrated therapeutic potential in experimental neonatal disease models.
• The therapeutic effects of MSCs are largely attributed to their secretome, with small extracellular vesicles (sEVs) identified as key paracrine mediators.
• This review examines the literature on MSC-derived EVs (MSC-EVs) as therapeutic agents for neonatal diseases.

Key Points:

• MSC-EVs represent a cell-free therapeutic approach, leveraging the paracrine mechanisms of MSCs.
• EVs encapsulate various bioactive molecules, including proteins, lipids, and nucleic acids, mediating therapeutic effects.
• Preclinical studies indicate MSC-EVs can mitigate inflammation, promote tissue repair, and improve outcomes in models of neonatal injury.

Conclusions:

• MSC-EVs hold significant potential as a therapeutic strategy for a range of neonatal diseases.
• Translation to clinical practice requires further research into standardization, manufacturing, and regulatory pathways.
• Addressing the challenges in MSC-EV therapy development is crucial for realizing their clinical benefits in neonatology.