Exosomes Entangle with Spinal Cord Injury: Miracles Arise from the Byproducts of Mesenchymal Stem Cells

Spinal cord injury (SCI) leads to sensory and motor dysfunction in the innervated regions below the injury level, and high-level SCI may even endanger the patient's life, causing a serious economic burden for both the patient and their family. Due to the non-renewable nature of spinal cord tissue, there is still no effective treatment strategy for patients with SCI. MSC-derived exosomes, as the main carriers through which MSCs exert paracrine effects, can transport bioactive molecules across biological barriers and regulate various physiological processes, including cell maintenance, immunosuppression, tissue repair, fibrosis inhibition, hematopoietic implantation, and angiogenesis. This article reviews the common causes and pathogenesis of SCI, the pathophysiology and characteristics of MSC-derived exosomes, preparation methods, and the application of transdermal stem-cellderived exosomes in SCI. Although several studies have demonstrated that MSC-derived exosomes show significant therapeutic potential for SCI, many aspects still require consideration, including standardized production, clinical application, social ethics, and potential side effects.