The impact of natural and engineered extracellular vesicles on post-myocardial infarction angiogenesis

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Myocardial infarction (MI) causes significant disintegration to the coronary microcirculation. Reperfusion following MI is essential to ensure the viability of cardiac tissue. Angiogenesis after MI involves interactions among various cell types, especially stem cells, which can be exploited as a promising therapeutic approach. Extracellular vesicles (EVs) transfer signaling molecules to adjacent cells in a paracrine manner, thereby playing a vital role in intercellular communication. This review summarizes the angiogenic regulating effects of EVs involved in the MI microenvironment and the therapeutic benefits of exogenous stem cell-derived EVs, and further clarifies the underlying mechanisms. We also discuss advanced methodologies to increase the yield and enhance the biological activities of engineered EVs to address major limitations preventing clinical applications to improve cardiac repair. Finally, highly efficient delivery systems are proposed to improve the efficacy of EVs for treatment of MI.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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