外泌体在卒中后认知障碍诊疗中的研究进展

doi:10.16352/j.issn.1001-6325.2026.06.0861

基础医学与临床 ›› 2026, Vol. 46 ›› Issue (6): 861-865.doi: 10.16352/j.issn.1001-6325.2026.06.0861

外泌体在卒中后认知障碍诊疗中的研究进展

王勇豪¹, 张卓钰², 苏铭恒³, 张琪^4*

1.陕西中医药大学临床医学院,陕西咸阳 712046;
2.山西医科大学第一临床医学院,山西太原 030001;
3.陕西中医药大学基础医学院,陕西咸阳 712046;
4.陕西中医药大学医学科研中心,陕西咸阳 712046

收稿日期:2025-05-09 修回日期:2025-07-14 出版日期:2026-06-05 发布日期:2026-05-27
通讯作者: ^*zhangqi@sntcm.edu.cn
基金资助:
国家自然科学基金(82074380)

Research progress in exosomes for the diagnosis and treatment of post-stroke cognitive impairment

WANG Yonghao¹, ZHANG Zhuoyu², SU Mingheng³, ZHANG Qi^4*

1. School of Clinical Medicine,Shaanxi University of Chinese Medicine,Xianyang 712046;
2. First Clinical Medical College,Shanxi Medical University, Taiyuan 030001,China;
3. School of Basic Medicine,Shaanxi University of Chinese Medicine,Xianyang 712046;
4. Medical Research Center,Shaanxi University of Chinese Medicine,Xianyang 712046

Received:2025-05-09 Revised:2025-07-14 Online:2026-06-05 Published:2026-05-27
Contact: ^*zhangqi@sntcm.edu.cn

摘要/Abstract

摘要： 外泌体可由卒中后认知障碍(PSCI)中不同细胞分泌,其通过影响神经炎性反应、血脑屏障、受损神经元修复、神经血管单元重建参与PSCI的发生发展,且较认知评估量表以及传统治疗药物具有早期诊疗优点。外泌体可作为PSCI新的诊断和治疗靶点,为PSCI的诊断和治疗提供新思路。

关键词: 外泌体, 卒中后认知障碍(PSCI), 血脑屏障, 神经炎性反应, 工程化外泌体

Abstract: Exosomes can be secreted by different cells in post-stroke cognitive impairment (PSCI) and participate in the occurrence and development of PSCI by affecting the neuroinflammatory response, the blood-brain barrier, repair of damaged neurons, and reconstruction of neurovascular unit. Compared with cognitive assessment scales and traditional treatment drugs, exosomes have the advantages of early diagnosis and treatment. Exosomes can be used as new diagnostic and therapeutic targets for PSCI, providing new ideas for the diagnosis and treatment of PSCI.

Key words: exosomes;post-stroke cognitive impairment (PSCI), blood-brain barrier, neuroinflammatory reaction, engineered exosomes

中图分类号:

R741

王勇豪, 张卓钰, 苏铭恒, 张琪. 外泌体在卒中后认知障碍诊疗中的研究进展[J]. 基础医学与临床, 2026, 46(6): 861-865.

WANG Yonghao. Research progress in exosomes for the diagnosis and treatment of post-stroke cognitive impairment[J]. Basic & Clinical Medicine, 2026, 46(6): 861-865.

参考文献 25

[1]	Swartz RH, Longman RS, Lindsay MP, et al. Canadian stroke best practice recommendations: vascular cognitive impairment, 7th edition practice guidelines update, 2024[J].Alzheimers Dement,2025,21:e14324. doi:10.1002/alz.14324.
[2]	Ge Y, Yang J, Chen J, et al. Absence in CX3CR1 receptor signaling promotes post-ischemic stroke cognitive function recovery through suppressed microglial pyroptosis in mice[J].CNS Neurosci Ther,2024,30:e14551. doi:10.1111/cns.14551.
[3]	Welsh JA, Goberdhan DCI, O′Driscoll L, et al. Minimal information for studies of extracellular vesicles (MISEV2023): from basic to advanced approaches[J].J Extracell Vesicles,2024,13:e12404. doi:10.1002/jev2.12404.
[4]	Zhang J, Buller BA, Zhang ZG, et al. Exosomes derived from bone marrow mesenchymal stromal cells promote remyelination and reduce neuroinflammation in the demyelinating central nervous system[J].Exp Neurol,2022,347:113895. doi:10.1016/j.expneurol.2021.113895.
[5]	Jiang Z, Wei J, Liang J, et al. Dl-3-n-butylphthalide alleviates secondary brain damage and improves working memory after stroke in cynomolgus monkeys[J].Stroke,2024,55:725-734. doi:10.1161/STROKEAHA.123.045037.
[6]	Xian X, Cai LL, Li Y, et al. Neuron secrete exosomes containing miR-9-5p to promote polarization of M1 microglia in depression[J].J Nanobiotechnology,2022,20:122-138. doi:10.1186/s12951-022-01332-w.
[7]	Pan X, Yang L, Wang S, et al. Semaglutide alleviates inflammation-induced endothelial progenitor cells injury by inhibiting miR-155 expression in macrophage exosomes[J].Int Immunopharmacol,2023,119:110196. doi:10.1016/j.intimp.2023.110196.
[8]	Min W, Wu Y, Fang Y, et al. Bone marrow mesenchymal stem cells-derived exosomal microRNA-124-3p attenuates hypoxic-ischemic brain damage through depressing tumor necrosis factor receptor associated factor 6 in newborn rats[J].Bioengineered,2022,13:3194-3206. doi:10.1080/21655979.2021.2016094.
[9]	Sun R, Liao W, Lang T, et al. Astrocyte-derived exosomal miR-378a-5p mitigates cerebral ischemic neuroinflammation by modulating NLRP3-mediated pyroptosis[J].Front Immunol,2024,15:1454116. doi:10.3389/fimmu.2024.1454116.
[10]	Liu C, Guo Y, Deng S, et al. Hemorrhagic stroke-induced subtype of inflammatory reactive astrocytes disrupts blood-brain barrier[J].J Cereb Blood Flow Metab,2024,44:1102-1116. doi:10.1177/0271678X241235008.
[11]	Jiang W, Wu Y, Pang A, et al. M1-type microglia-derived exosomes contribute to blood-brain barrier damage[J].Brain Res,2024,1835:148919. doi:10.1016/j.brainres.2024.148919.
[12]	Ji Y, Gao Q, Ma Y, et al. An MMP-9 exclusive neutralizing antibody attenuates blood-brain barrier breakdown in mice with stroke and reduces stroke patient-derived MMP-9 activity[J].Pharmacol Res,2023,190:106720. doi:10.1016/j.phrs.2023.106720.
[13]	Wang H, Chen FS, Zhang ZL, et al. miR-126-3p-enriched extracellular vesicles from hypoxia-precondi-tioned VSC 4.1 neurons attenuate ischaemia-reperfusion-induced pain hypersensitivity by regulating the PIK3R2-mediated pathway[J].Mol Neurobiol,2021,58:821-834. doi:10.1007/s12035-020-02159-y.
[14]	Xin H, Liu Z, Buller B, et al. miR-17-92 enriched exosomes derived from multipotent mesenchymal stromal cells enhance axon-myelin remodeling and motor electrophysiological recovery after stroke[J].J Cereb Blood Flow Metab,2021,41:1131-1144. doi:10.1177/0271678X20950489.
[15]	Antoniou A, Auderset L, Kaurani L, et al. Neuronal extracellular vesicles and associated microRNAs induce circuit connectivity downstream BDNF[J].Cell Rep,2023,42:112063. doi:10.1016/j.celrep.2023.112063.
[16]	Pan Q, Kuang X, Cai S, et al. miR-132-3p priming enhances the effects of mesenchymal stromal cell-derived exosomes on ameliorating brain ischemic injury[J].Stem Cell Res Ther,2020,11:260-276. doi:10.1186/s13287-020-01761-0.
[17]	Hu H, Hu X, Li L, et al. Exosomes derived from bone marrow mesenchymal stem cells promote angiogenesis in ischemic stroke mice via upregulation of miR-21-5p[J].Biomolecules,2022,12:883-900. doi:10.3390/biom12070883.
[18]	Bao H, Mao S, Hu X, et al. Exosomal miR-486 derived from bone marrow mesenchymal stem cells promotes angiogenesis following cerebral ischemic injury by regulating the PTEN/Akt pathway[J].Sci Rep,2024,14:18086. doi:10.1038/s41598-024-69172-2.
[19]	Yuan M, Guo YS, Zhang XX, et al. Diagnostic performance of miR-21, miR-124, miR-132, and miR-200b serums in post-stroke cognitive impairment patients[J].Folia Neuropathol,2022,60:228-236. doi:10.5114/fn.2022.118187.
[20]	Qi B, Kong L, Lai X, et al. Plasma exosome proteomics reveals the pathogenesis mechanism of post-stroke cogni-tive impairment[J].Aging (Albany NY),2023,15:4334-4362. doi:10.18632/aging.204738.
[21]	Chen C, Feng D, Lu F, et al. Neuroprotective effects of exosomes derived from bone marrow mesenchymal stem cells treated by Musk Ketone on ischemic stroke[J].J Stroke Cerebrovasc Dis,2024,33:107628. doi:10.1016/j.jstrokecerebrovasdis.2024.107628.
[22]	Ding W, Gu Q, Liu M, et al. Astrocytes-derived exosomes pre-treated by berberine inhibit neuroinflamma-tion after stroke via miR-182-5p/Rac1 pathway[J].Int Immunopharmacol,2023,118:110047. doi:10.1016/j.intimp.2023.110047.
[23]	Li B, Chen X, Qiu W, et al. Synchronous disintegration of ferroptosis defense axis via engineered exosome-conjugated magnetic nanoparticles for glioblastoma therapy[J].Adv Sci (Weinh),2022,9:e2105451. doi:10.1002/advs.202105451.
[24]	Gu C, Li Y, Liu J, et al. Neural stem cell-derived exosomes-loaded adhesive hydrogel controlled-release promotes cerebral angiogenesis and neurological function in ischemic stroke[J].Exp Neurol,2023,370:114547. doi:10.1016/j.expneurol.2023.114547.
[25]	Hu WJ, Wei H, Cai LL, et al. Magnetic targeting enhances the neuroprotective function of human mesen-chymal stem cell-derived iron oxide exosomes by delivering miR-1228-5p[J].J Nanobiotechnology,2024,22:665-713. doi:10.1186/s12951-024-02941-3.

外泌体在卒中后认知障碍诊疗中的研究进展

Research progress in exosomes for the diagnosis and treatment of post-stroke cognitive impairment

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