Exosomes in subarachnoid hemorrhage: A scoping review

Area of Science:

• Neuroscience
• Biomedical Engineering
• Regenerative Medicine

Background:

• Subarachnoid hemorrhage (SAH) frequently leads to vasospasm, exacerbating ischemia and brain injury, significantly impacting patient outcomes.
• Current vasospasm treatments offer limited efficacy and unclear clinical benefits.
• Exosomes, particularly their microRNA (miRNA) cargo, are emerging as a potential therapeutic strategy for vasospasm.

Purpose of the Study:

• To conduct a scoping review of existing literature on the role of exosomes in the context of SAH.
• To identify and analyze studies investigating exosomal profiles and therapeutic applications in SAH.

Main Methods:

• A systematic scoping review was performed following PRISMA guidelines.
• Literature searches were conducted in PubMed and Scopus databases.
• Included studies focused on exosomal profiles or therapies for SAH and early brain injury (EBI).

Main Results:

• Seven papers were included, with two analyzing endogenous exosome profiles post-SAH.
• Four studies characterized miRNA-based exosomal therapies for attenuating EBI.
• All therapeutic studies indicated anti-apoptotic and anti-inflammatory effects of miRNA exosomes via specific molecular pathways (BDNF/TrkB/CREB or HDAC3/NF-κB).

Conclusions:

• miRNA-based exosomal treatments show potential neuroprotective benefits for EBI and SAH.
• Further research is recommended to explore the anti-inflammatory and anti-apoptotic roles of exosomal miRNA delivery in SAH.
• Targeting identified common molecular pathways (BDNF/TrkB/CREB or HDAC3/NF-κB) in future SAH exosome therapy is suggested.