Cardiac cell-derived exosomes – the holy grail of cardiac medicine

Repair of the damaged cardiac tissue has been considered the holy grail of cardiac medicine driving researchers for years. Myocardial damage in an adult heart leads to widespread cardiomyocyte loss without active replacement of the dead cardiac tissue, ultimately resulting in formation of scar at the site of injury. Current therapies are designed only to limit the extent of scar formation and are unable to offer restoration of lost cardiac tissue, leading to a progressive decline in cardiac function. As a consequence, cardiac diseases continue to rise and are a significant cause of morbidity and mortality around the world. The last 10 years have witnessed the dawn of stem cell therapy for cardiac repair with promising true cellular replacement and restoration of cardiac tissue damaged due to pathological injury. Multiple stem cell types derived from bone marrow, heart, adipose tissue, and cortical bone have been tested in small and large animal models of myocardial damage. Among these, stem cells derived from the heart hold particular interest and represent the most suitable cell type for cardiac repair. Different populations of cardiac stem cells have been reported to date and, importantly, all of them have been shown to differentiate into three cardiac cell types, i.e. myocytes, endothelial cells, and smooth muscle cells, contribute towards neovascularization, and significantly improve function after myocardial damage

Exosome therapy recapitulates the benefits of cell therapy

exosome rna

CDC derived exosomes are generated by inward budding of endosomal membranes and accumulate in multivesicular bodies. They are released into extracellular space following the fusion of the endosomal compartment with the plasma membrane. Their cargo consists mainly of proteins and nucleic acids, with the greatest abundance and variety presented by miRNA and mRNA. Delivery of CDC exosomes to heart after injury recapitulates cardiac structural and functional effects, angiogenesis and immune modulation as seen by cell therapy.

The discovery of tiny shuttles called ‘exosomes’ secreted by cells in response to changes in their physiological environment represents a paradigm shift in the way we look at biological processes. First described 30 years back, exosomes were long regarded to be nothing more than cellular garbage, a way for the cells to remove unwanted debris. Since then, exosomes have exploded onto the field, regulating diverse molecular processes, proposed as biomarkers, and play vital role in progression of disease including cardiovascular disorders. In particular, exosomes for cardiac repair and regeneration have generated significant interest as an alternative to cell therapy…(read more)

Kishore R, Khan M. (2016) Cardiac cell-derived exosomes: changing face of regenerative biology. Eur Heart J [Epub ahead of print]. [abstract]

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