肿瘤细胞治疗研究
英文原题:Exosome-Based Approaches in Regenerative Medicine and Targeted Therapy for Eye Malignancies: A Comprehensive Review.
Exosome-Based Approaches in Regenerative Medicine and Targeted Therapy for Eye Malignancies: A Comprehensive Review.
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眼部恶性肿瘤较为罕见,病理生理机制复杂,且可能发生威胁视力或生命的并发症,因此葡萄膜黑色素瘤、视网膜母细胞瘤、眼内淋巴瘤和结膜肿瘤等疾病的诊断与治疗颇具挑战。化疗、放疗和手术等传统治疗因全身毒性、多重耐药及局部控制不足,临床价值有限。外泌体(EXO)是天然存在、具有生物相容性结构的纳米级囊泡,可跨越眼部屏障递送微小RNA、蛋白质和/或基因编辑分子,为精准诊断、药物递送和免疫调节提供独特且有利的平台。间充质干细胞来源外泌体(MSC-EXO)在动物和人类视网膜及眼损伤模型中也具有再生潜力,可调节包括HMGB1及PI3K/AKT通路在内的炎症和神经保护相关生物学通路。尽管EXO用于眼病治疗前景良好,但分离标准化、规模化生产和监管等因素仍使临床转化复杂化。
总体而言,随着合成及生物工程化EXO不断涌现,基于EXO的纳米医学有望成为精准治疗和再生眼科学的新方向,并为开发可规模化且可进行生物学定制的EXO疗法开辟新途径。
Diagnosing and treating ocular malignancies-such as uveal melanoma, retinoblastoma, intraocular lymphoma, and conjunctival tumors-can be very difficult given their rarity, complicated pathophysiology, and a high potential for complications that threaten vision or life. Traditional treatments such as chemotherapy, radiation, and surgery result in limited clinical value because of systemic toxicity, versatile drug resistance, and insufficient local control. Exosomes (EXOs)-naturally occurring nanoscale vesicles held in biocompatible structures-represent a uniquely advantageous platform for targeting and delivering miRNAs, proteins and/or gene editing molecules across ocular barriers to create corrective, sustained, and targeted diagnostics, drug delivery, and immune modulation.
Mesenchymal stem cell-derived exosomes (MSC-EXOs) also possess regenerative potential in both animal and human models of retinal and ocular injury, engaging biological pathways involved in modulating inflammation and neuroprotection such as HMGB1 and PI3K/AKT pathways. While the use of EXOs presents a promising option for ocular treatment application, several factors complicate actual clinical translation, including standardization of isolation, scalable manufacture, and regulatory issues.
In general, EXO-based nanomedicine may be a promising new direction for precision therapy and regenerative ophthalmology with the increasing introduction of synthetic and bioengineered EXOs introducing precursor paving new avenues for clinically scalable and biologically customizable EXO therapeutics.
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