细胞外囊泡在神经系统疾病中的治疗潜力

doi:10.12122/j.issn.1673-4254.2025.09.24

摘要/Abstract

摘要：

细胞外囊泡（EVs）是由生物体主动释放到细胞外环境的纳米级脂质双层囊泡，富含特定的生物活性物质，如蛋白质、遗传物质和脂质等。由于这些囊泡参与细胞间相互作用，并且能透过血脑屏障，它们可能是治疗神经系统疾病的重要生物物质。在本文中，我们介绍了EVs生物起源及在神经系统疾病中治疗的潜力，并着重阐述了基于EVs在中药中治疗神经系统疾病的可能性，最后讨论了EVs治疗神经系统疾病研究领域的挑战和前景。

关键词: 细胞外囊泡, 神经系统疾病, 治疗, 载药疗法

Abstract:

Extracellular vesicles (EVs), nanoscale lipid bilayer vesicles actively secreted by organisms into the extracellular environment, are rich in specific bioactive substances, such as proteins, genetic materials and lipids. These vesicles are involved in intercellular interactions and can pass through the blood-brain barrier, and may thus potentially serve as important biological substances for treatment of neurological diseases. In this review, we summarize the biological origin of EVs and their therapeutic potential in neurological diseases, expound the possibility of EV-based treatment of neurological diseases using traditional Chinese medicine, and discuss the challenges and prospects of researches of EVs for the treating neurological diseases.

Key words: extracellular vesicles, neurological disorders, treatment, medicated therapy

杜庆锋, 杨超, 夏雪晴, 王婷. 细胞外囊泡在神经系统疾病中的治疗潜力[J]. 南方医科大学学报, 2025, 45(9): 2046-2054.

Qingfeng DU, Chao YANG, Xueqing XIA, Ting WANG. Therapeutic potential of extracellular vesicles in neurological diseases[J]. Journal of Southern Medical University, 2025, 45(9): 2046-2054.

图/表 2

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Classification	Subgroup	Size (nm)	Biomarkers	Origin
Exomeres		-35	Hsp90-β	Endosomes
Exosomes	Exo-S	60-80	Tetraspanins, Tsg101, Alix, flotillin, Hsp70
Exosomes	Exo-L	90-120	Tetraspanins, Tsg101, Alix, Hsp70
Microvesicles		150-1000	Integrins, selectins, CD40	Plasma membrane
Apoptotic bodies		500-2000	Phosphatidylserine, genomic DNA	Plasma membrane, endoplasmic reticulum
Migrasomes		500-3000	Tetraspanins, chemokines, cytokines, growth factors, cholesterol	Retraction fibers

Classification	Subgroup	Size (nm)	Biomarkers	Origin
Exomeres		-35	Hsp90-β	Endosomes
Exosomes	Exo-S	60-80	Tetraspanins, Tsg101, Alix, flotillin, Hsp70
Exosomes	Exo-L	90-120	Tetraspanins, Tsg101, Alix, Hsp70
Microvesicles		150-1000	Integrins, selectins, CD40	Plasma membrane
Apoptotic bodies		500-2000	Phosphatidylserine, genomic DNA	Plasma membrane, endoplasmic reticulum
Migrasomes		500-3000	Tetraspanins, chemokines, cytokines, growth factors, cholesterol	Retraction fibers

Disease	Sources of EVs	Cargos	Mechanism and function	Referen-ces
Alzheimer's disease	Bone marrow MSCs		Reduced Aβ and amyloid deposition	48
	MSCs		MSC-derived exosomal miR-223 inhibited the apoptosis of neurons by targeting PTEN, activating the PI3K/Akt pathway	49
	Hippocampus neuron cell		Fe65-EXO-Cory-B blocked the natural interaction between Fe65 and APP, induceing autophagy in APP-expressing neuronal cells	50
	MSCs		Reduced plaque deposition and Aβ	51
	Macrophages	Silibinin	Reducing Aβ aggregation and deactivating astrocytes	52
	Cells	Curcumin	Inhibiting phosphorylation of the Tau protein through activating the AKT/GSK-3β pathway	53
	Rat plasma	Quercetin	Inhibiting cyclin-dependent kinase 5-mediated phosphorylation of Tau and reducing formation of insoluble neurofibrillary tangles	54
Parkinson's disease	Dendritic cells	shRNA minicircles	Decreased alpha-synuclein aggregation, reduced the loss of dopaminergic neurons	56
	Epicatechin gallate		Inhibiting caspase 3, increase the Bcl-2/BAX ratioto reduce apoptosis	57
	MSCs		Stimulating ICAM1-SMAD3/ P38MAPK pathway	58
	Astrocytes		miR-200a-3p suppressed MKK4 expressions	59
	MSCs	Curcumin	PR-EXO/PP@Cur targets the reductionα-synuclein aggregates, promotes neuron function recovery, and alleviates the neuroinflammation	60
	MSCs	Dihydrotanshinone I	Inhibition of peripheral inflammatory cell infiltration, precise regulation of inflammatory microglia in the substantia nigra	61

Disease	Sources of EVs	Cargos	Mechanism and function	Referen-ces
Alzheimer's disease	Bone marrow MSCs		Reduced Aβ and amyloid deposition	48
	MSCs		MSC-derived exosomal miR-223 inhibited the apoptosis of neurons by targeting PTEN, activating the PI3K/Akt pathway	49
	Hippocampus neuron cell		Fe65-EXO-Cory-B blocked the natural interaction between Fe65 and APP, induceing autophagy in APP-expressing neuronal cells	50
	MSCs		Reduced plaque deposition and Aβ	51
	Macrophages	Silibinin	Reducing Aβ aggregation and deactivating astrocytes	52
	Cells	Curcumin	Inhibiting phosphorylation of the Tau protein through activating the AKT/GSK-3β pathway	53
	Rat plasma	Quercetin	Inhibiting cyclin-dependent kinase 5-mediated phosphorylation of Tau and reducing formation of insoluble neurofibrillary tangles	54
Parkinson's disease	Dendritic cells	shRNA minicircles	Decreased alpha-synuclein aggregation, reduced the loss of dopaminergic neurons	56
	Epicatechin gallate		Inhibiting caspase 3, increase the Bcl-2/BAX ratioto reduce apoptosis	57
	MSCs		Stimulating ICAM1-SMAD3/ P38MAPK pathway	58
	Astrocytes		miR-200a-3p suppressed MKK4 expressions	59
	MSCs	Curcumin	PR-EXO/PP@Cur targets the reductionα-synuclein aggregates, promotes neuron function recovery, and alleviates the neuroinflammation	60
	MSCs	Dihydrotanshinone I	Inhibition of peripheral inflammatory cell infiltration, precise regulation of inflammatory microglia in the substantia nigra	61