Unpacking the role of exosomal proteins and nucleic acids in ischemic stroke: Insights from diverse cellular sources

Ischemic stroke (IS) is one of a leading cause of global mortality and disability. Cell therapy has emerged as a novel adjunctive therapy. Studies have revealed that exosomes secreted by cells mediate the beneficial effects of such therapies. Exosomes derived from different cell types exert distinct functions in IS, and contribute to post-IS angiogenesis, neuronal activity and regeneration, and the anti-inflammatory activity of immune cells, which thereby offers promising avenues for IS treatment. However, current studies lack a systematic and comparative analysis of exosomes from various cell sources, especially regarding the functional differences of their cargo components (e.g., proteins and nucleic acids). Exosomes from stem cells (SCs), non-stem cells (nSCs), and plants were reviewed for their characteristics, challenges, and preclinical animal studies in IS therapy. The purpose was to explore the positive roles and potential therapeutic targets of exosomes from diverse origins during IS treatment, and provide a reference for the development of future exosome-based interventions against stroke pathology.