Therapeutic Potential of Preconditioned Stem Cell–Derived Exosomes for Neurorestoration in Brain Injury
DOI:
https://doi.org/10.57213/medlab.v5i1.427Keywords:
Brain Injury, Neurorestoration, Preconditioned Exosome, Regenerative Medicine, Stem CellAbstract
Brain injury, both traumatic and ischemic, remains a leading cause of long-term neurological disability worldwide, while current therapies are limited to rehabilitation and supportive care. In recent years, stem cell–derived exosomes have emerged as a promising cell-free therapy capable of crossing the blood–brain barrier and promoting neuronal repair. This literature review aims to evaluate the neurorestorative potential of preconditioned stem cell–derived exosomes after brain injury and to identify how various preconditioning strategies enhance their biological efficacy. A systematic literature search was conducted using PubMed and ScienceDirect databases following the PRISMA 2020 framework. The review process involved four stages (identification, screening, eligibility, and inclusion) based on predefined inclusion and exclusion criteria following the PICOS model. A total of 212 articles were initially identified, and after full-text assessment, 5 studies met the inclusion criteria and were analyzed descriptively. All included studies employed in vivo experimental designs using rodent models of traumatic brain injury, ischemic stroke, or oxygen–glucose deprivation. The analysis demonstrated that preconditioning methods, such as hypoxia exposure, cytokine (IFN-γ) stimulation, pharmacologic modulation with berberine, and infarct microenvironment conditioning, significantly enriched the exosomal cargo with bioactive molecules, including miR-125a-5p, miR-182-5p, miR-206, VEGF, and BDNF. These molecular alterations enhanced neurogenesis, angiogenesis, and immunomodulation, resulting in improved neurological outcomes without systemic toxicity. Preconditioned exosome therapy exhibits strong potential as a safe, effective, and clinically translatable cell-free regenerative approach for neurorestoration following brain injury. Further large-scale preclinical studies and early-phase clinical trials are warranted to standardize preconditioning protocols and confirm long-term safety.
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