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Exosome-mediated amplification of endogenous brain repair mechanisms and brain and systemic organ interaction in modulating neurological outcome after stroke
Abstract
Ischemic stroke is caused by a regional interruption of cerebral blood flow to the brain. Rigorous pre-clinical and clinical research has made landmark progress in stroke treatment using thrombolytics and endovascular thrombectomy. Although numerous successful neuroprotective therapeutic agents for ischemic stroke have been reported in pre-clinical studies, most of them failed in clinical testing. Persistent pre-clinical research has demonstrated that the ischemic brain is not only passively dying but is also actively recovering. Within the neurovascular niche in the peri-infarct tissue, repair mechanisms thrive on the interactions between the neural and vascular compartments. In this review, we discuss exogenous therapy using mesenchymal stromal cell-derived exosomes to amplify endogenous brain repair mechanisms and to induce neurorestorative effects after stroke. Emerging evidence indicates that multiple communication axes between the various organs such as the brain, heart, kidney and gut, and whole body immune response mediated by the spleen can also affect stroke outcome. Therefore, in this review, we summarize this evidence and initiate a discussion on the potential to improve stroke outcome by amplifying multiple brain repair mechanisms after stroke, and by targeting peripheral organs and downstream events to enhance recovery in the injured brain and promote over all well being.
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“Recent studies have shown that exosomes play an important role in the delivery of miR-124 [16, 21, 22].”
From CX3CL1/CX3CR1 axis attenuates early brain injury via promoting the delivery of exosomal microRNA-124 from neuron to microglia after subarachnoid hemorrhage (2020) · cites this paper as [21]
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Cited by
Sorted by citations
Venkat, P., Cui, C., Chopp, M., Zacharek, A., Wang, F., Landschoot-Ward, J., Shen, Y., & Chen, J. (2019) · Stroke · doi:10.1161/strokeaha.119.025371 · Cited by 172
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Yarahmadi, A., Dorri Giv, M., Hosseininejad, R., Rezaie, A., Mohammadi, N., Afkhami, H., & Farokhi, A. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1472679 · Cited by 21
Metadata
- Authors
- Venkat, P., Chen, J., & Chopp, M.
- Affiliations
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
- ORCID
- Venkat, Poornima
- Venue
- Journal of Cerebral Blood Flow & Metabolism
- Publisher
- SAGE Publications
- Published
- 2018-06-11
- Volume
- 38
- Issue
- 12
- Pages
- 2165-2178
- ISSN
- 0271-678X
- 1559-7016
- Cited by
- 65
- References
- 13
- Language
- en
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