Ayse Melis Ozdemir
, Helin Lara Senoglu
, Mohammadreza Dastouri
* 1 Department of Medical Biology, Faculty of Medicine and Genetics, Ankara Medipol University, Ankara, Turkey
Abstract
The use of exosomes derived from stem cells as microRNA (miRNA) delivery vehicles for neuroregenerative medicine is an area that is gaining increasing attention. Their biocompatible natural structure and ability to effectively interact with target cells make these nanometric vesicles a candidate of interest for modulating nerve repair mechanisms. The scalability of exosome production and the standardization of isolation methods still require further development. Furthermore, miRNAs are being increasingly investigated due to their roles in regulating gene expression and neuronal survival and regeneration through various pathways in which they participate. This review examines current information on the biogenesis and molecular profile of stem cell-derived exosomes, as well as various endogenous and bioengineering-based strategies for miRNA loading. Besides, mechanisms including ESCRT-dependent and ESCRT-independent pathways, as well as other physical and chemical processes, are explained in terms of specificity and effectiveness. Furthermore, this review assesses the vast therapeutic promise of miRNA-loaded exosomes in enhancing neurogenesis, regulating inflammation, preserving synaptic plasticity, and inhibiting apoptosis. Special attention is also paid to experimental findings in various neurodegenerative disorders such as Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Huntington’s, and spinal cord injuries, and translational challenges in these areas. Finally, emerging approaches, such as personalized exosome-based therapies, gene editing tools like CRISPR, and integrated therapeutic platforms, are discussed in this review as elements that may shape future developments.