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Review
. 2022 Jul 28;23(15):8367.
doi: 10.3390/ijms23158367.

Utility of Exosomes in Ischemic and Hemorrhagic Stroke Diagnosis and Treatment

Eun Chae Lee  1   2 , Tae Won Ha  2 , Dong-Hun Lee  1   2 , Dong-Yong Hong  1   2 , Sang-Won Park  1   2 , Ji Young Lee  1 , Man Ryul Lee  2 , Jae Sang Oh  1
Affiliations
Review

Utility of Exosomes in Ischemic and Hemorrhagic Stroke Diagnosis and Treatment

Eun Chae Lee et al. Int J Mol Sci. .

Abstract

Stroke is the leading cause of death and neurological disorders worldwide. However, diagnostic techniques and treatments for stroke patients are still limited for certain types of stroke. Intensive research has been conducted so far to find suitable diagnostic techniques and treatments, but so far there has been no success. In recent years, various studies have drawn much attention to the clinical value of utilizing the mechanism of exosomes, low toxicity, biodegradability, and the ability to cross the blood-brain barrier. Recent studies have been reported on the use of biomarkers and protective and recovery effects of exosomes derived from stem cells or various cells in the diagnostic stage after stroke. This review focuses on publications describing changes in diagnostic biomarkers of exosomes following various strokes and processes for various potential applications as therapeutics.

Keywords: exosome; exosome isolation; extracellular vesicles; hemorrhagic stroke; ischemic stroke; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Exosome surface, components of exosome secretion, and interactions between extracellular vesicles (EVs) and recipient cells. EV membrane proteins can be delivered to receptor molecules on the surface of recipient cells, where they trigger signaling cascades. EV membrane proteins can also be cleaved by proteases and converted into soluble fragments that serve as ligands for their cell receptors. EVs can fuse with the membrane of the recipient cell to transfer cargo to the recipient cell. Migrated exosomes can be activated in the recipient cell in several ways. The secreted exosome fuses to the target cell and assists receptor–ligand interaction and endocytosis.
Figure 2
Figure 2
Exosomes are involved in different ways in ischemic and hemorrhagic strokes. Different roles of exosomes in (A) angiogenesis, (B) neurogenesis, (C) autophagy, and (D) blood–brain-barrier in ischemic stroke and hemorrhagic stroke.
Figure 3
Figure 3
Exosomes as diagnostic markers (1). Blood and CSF are collected after the patient develops (2). After that, exosomes are extracted (3) and diagnosis is performed through sequencing, polymerase chain reaction, and proteomics (4). Schematic representation of the procedure for using exosomes as diagnostic markers for the rapid diagnosis of ischemic and hemorrhagic strokes (5). Afterwards, the point of care test can reduce the time by explaining the on-site diagnosis result to the patient (6).
Figure 4
Figure 4
Therapeutic value about stroke mechanism. Mechanism of exosomes as therapeutic agents: (1) Prion proteins are associated with cell defense against hypoxia and damage caused by ischemia (2) Endotheliological progenitor cell derived exosome reduces neurologic definitions (3) Embryonic stem cell exosomes (MESC-exotic) containing curcumin reduce ROS-related genes (4) Exosomes derived from bone marrow stem cells inhibit microglia inflammation and protect microglia from inflammatory neurotoxicity.
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