间充质干细胞来源外泌体及衍生miRNA 治疗病理性瘢痕的作用机制.

BACKGROUND: Stem cell therapy has become an emerging method of treating pathological scars. miRNAs are involved in scarring mechanisms, and the targeted action of some stem cell sources of miRNA is mediated by exosomes. OBJECTIVE: To review the biological properties of miRNA derived from mesenchymal stem cells and its derivatives, the mechanism of treatment of scarring through anti-inflammation, suppression of excessive tissue reconstruction and antioxidation. METHODS: The first author used a computer in September 2023 to retrieve the relevant literature published from January 2000 to September 2023, searching for “stem cell, exosome, miRNA, keloid” in English, and “stem cells, exosome, keloid” in Chinese, eventually incorporating 74 papers for analysis. RESULTS AND CONCLUSION: (1) miRNAs with high expression of exosomes derived from mesenchymal stem cells increase the proportion of M2-type macrophages by promoting the polarization of macrophages, target the regulation of transforming growth factor β, transforming growth factor β receptors or related signaling pathways, inhibit the expression of pro-inflammatory factors, promote the expression of anti-inflammatory factors and other mechanisms to inhibit inflammation and thus suppress scar lesions. (2) miRNAs with high expression of exosomes derived from mesenchymal stem cells can reduce the secretion of matrix metalloproteinases, regulate the balance between matrix metalloproteinase inhibitors and matrix metalloproteinases, inhibit the proliferation and migration of fibroblasts and myofibroblasts, directly reduce the production of collagen and other mechanisms, and ultimately lead to the normal degradation of extracellular matrix, thereby inhibiting excessive tissue remodeling and cicatricial lesions. (3) miRNAs with high expression of exosomes from mesenchymal stem cells can improve the resistance of scar fibroblasts to oxidative stress by regulating reactive oxygen species and hypoxia-inducing factors, and then regulate the proliferation and apoptosis of scar fibroblasts to inhibit scar lesions. (4) Exosomes derived from mesenchymal stem cells have good prospects for scar treatment. Studies on this aspect can find mirnas that regulate inflammatory cells, inflammatory factors, signaling pathways, matrix metalloproteinases, fibroblasts, reactive oxygen species, hypoxia-inducing factors and other key factors from the three aspects of inflammation, tissue remodeling and oxidative stress. Then, by inducing mesenchymal stem cells with high expression of the above miRNA, exosomes were extracted, and finally verified and clinical trials were carried out. [ABSTRACT FROM AUTHOR]