3rd International Congress on Biomedicine (ICB2019)
A review on extracellular vesicles ( exosome ) from Umbilical cord stem cells as a therapeutic treatment on Perinatal brain injury
A review on extracellular vesicles ( exosome ) from Umbilical cord stem cells as a therapeutic treatment on Perinatal brain injury
Amir Ali Orang Zaman ,1,*Mina Yamani,2
1. Islamic Azad University, Tehran Medical Branch 2. Islamic Azad University, North Tehran Branch
Introduction: In the past decade, medical science has evolved exponentially. Yet, one of our weaknesses in medical science remains disturbances to the nervous system and related injuries. Currently, we have very limited treatment options; one of the common said injuries is perinatal brain injuries, which is a complication, accrued in prematurely born infants. Studies have shown related influences on schooling performance and everyday life skills, which will persist throughout their lives. The pathogenesis of prenatal brain injuries comes down to neonatal hypoxia/ischemia and inflammation, which can cause disturbance to brain residence immune cells and therefore releasing of free radicals. As a result, it will cause damage to preterm white matter, which at this point are in the form of immature oligodendrocytes. As shown in past studies are highly sensitive to these factors due to proliferation complications. Mesenchymal stromal stem cells (MSC) are good prospects for neuroprotection and proliferation, MSC has shown proliferating effects and cell death prevention. Moreover, several studies on rats confirmed the neural regeneration effects after inflammation and hypoxic-ischemic. Now the previous assumption was MSC are replacing the damaged cells but a very recent study has proven that extracellular vesicles and exosomes secreted by MSC are responsible for these effects. In this study, we have conducted a review on the pathogenesis and suggested a biotechnological solution to several problems.
Methods: All the studies have been carried through published literature using Thompson Reuters database ISI Web of Science, Google Scholar, NCBI PubMed, and Elsevier database. The study was focused on PBI effects throughout life psychological problems as well as memory deficits, understanding the pathogenesis of PBI, Greymatter necrosis and apoptosis, and myelination of immature oligodendrocyte and further proliferation, understanding the quantitative route for measuring neuron-specific cell death, morris water maze, and related data analysis methods. All the candidate publications abstracts were read to identify the highest relevancy and further analysis.
Results: There are multiple recent studies focused on stem cells as a potential treatment for neuronal damage. PBI is neuronal damage and has unique pathogenesis in which proliferation of oligodendrocytes is interrupted and neuron-specific cell death occurring via apoptosis and necrosis of neurons in the gray matter of the brain.
Our studies have shown that administration of isolated extracellular vesicles of mesenchymal stem cell has a protective effect on white and gray matter injuries, these results are in line with previous publications.
Now further experiments are required to distinguish pharmacological properties of MSC-EV as a treatment for PBI, a study has shown that intranasal administration of MSC-EV is an optimal balance between effectiveness and invasiveness of delivery.
Clinical trial and post-treatment monitoring is a necessity for human applications, post-treatment monitoring has to be done through hard labor but clinical trial aspects such as effective dose-measuring, and ideal therapeutic window can be processed via biotechnological research to increase accuracy and decrease time consumption of such trails.
Conclusion: In conclusion, we showed that MSC-EV application has remarkably prevented perinatal brain injury and represent a potential treatment strategy preterm PBI in human newborns. We have also represented knowledge of PBI pathogenesis and quantitative analysis method for a basic understanding of such matters in further biotechnological studies, and clinical trials.
Stem cells and their capacity to prevent white and gray matter alteration as well as apoptosis and necrosis prevention and especially their improvement capability on long term neurodevelopmental outcome are a potential and novel perspective in medical science and a good understanding and foundation are necessary to accelerate research and result and further expanding medical possibilities.