The Evolving Role of Mesenchymal Stem Cells and Their Exosomes in Epilepsy Management: From Bench to Bedside

Epilepsy affects over 70 million individuals globally, with nearly one-third of patients failing to achieve seizure control despite the continued availability of new technologies and medications. Current epilepsy research aims to prevent or arrest the onset and progression of epilepsy by seeking novel therapeutic targets and developing potent medications. Neuroinflammatory pathways may underlie the core pathophysiology of epileptogenesis, according to evidence from clinical and fundamental research. Intervening in neuroinflammatory pathways can delay the onset and progression of epilepsy. Mesenchymal stem cells (MSCs) have recently garnered notable attention for their robust immunomodulatory and anti-inflammatory properties in the context of inflammatory and immune-mediated diseases, suggesting their potential as promising candidates in epilepsy management. The therapeutic efficacy of MSCs is largely ascribed to their paracrine function, particularly exosomes, as confirmed by numerous pertinent studies. This review synthesizes preclinical and clinical studies of MSCs and their exosomes in epilepsy treatment, elucidating their mechanisms of action. Collectively, these studies indicate that MSCs and their exosomes have the potential to serve as innovative epilepsy treatment in the future. Trial Registration: ClinicalTrials.gov identifier: NCT05886205.