Therapeutic Potential of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Ischemic Stroke: A Meta-Analysis of Preclinical Studies

Xiaoming Zhang; Yibing Guo; Kun Fang; Xiangqian Huang; Duo Lan; Mengqi Wang; Lina Jia; Xunming Ji; Ran Meng; Da Zhou

doi:10.1016/j.brainresbull.2025.111219

Therapeutic Potential of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Ischemic Stroke: A Meta-Analysis of Preclinical Studies

Brain Res Bull. 2025 Jan 19:111219. doi: 10.1016/j.brainresbull.2025.111219. Online ahead of print.

Authors

Xiaoming Zhang¹, Yibing Guo², Kun Fang³, Xiangqian Huang⁴, Duo Lan⁵, Mengqi Wang⁶, Lina Jia⁷, Xunming Ji⁸, Ran Meng⁹, Da Zhou¹⁰

Affiliations

¹ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
² Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
³ Capital Medical University, Beijing, 100069, China. Electronic address: [email protected].
⁴ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
⁵ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
⁶ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
⁷ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
⁸ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
⁹ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].
¹⁰ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100053, China; National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. Electronic address: [email protected].

PMID: 39837375
DOI: 10.1016/j.brainresbull.2025.111219

Abstract

Background: Ischemic stroke (IS) remains a significant global health burden, necessitating the development of novel therapeutic strategies. This study aims to systematically evaluate the therapeutic effects of mesenchymal stem cell-derived exosomes (MSC-Exos) on IS outcomes in rodent models.

Methods: A comprehensive literature search was conducted across multiple databases to identify studies investigating the effects of MSC-Exos on rodent models of IS. Following rigorous inclusion and exclusion criteria, 73 high-quality studies were selected for meta-analysis. Primary outcomes included reductions in infarct volume/ratio and improvements in functional recovery scores. Data extraction and analysis were performed using RevMan 5.3 software.

Results: Pooled data indicated that MSC-Exos administration significantly reduced infarct size and improved functional recovery scores in rodent models of IS. Treatment within 24hours and beyond 24hours of stroke induction both demonstrated substantial reductions in infarct volume/ratio compared to controls. Furthermore, MSC-Exos-treated groups exhibited marked improvements in functional recovery, as assessed by various neurobehavioral tests. The meta-analysis showed no significant publication bias, and heterogeneity levels were acceptable.

Conclusions: MSC-Exos reveal significant therapeutic potential for IS, with evidence supporting their efficacy in reducing infarct size and enhancing functional recovery in preclinical rodent models. These findings pave the way for further research and potential clinical translation.

Keywords: Extracellular vesicles; Ischemic stroke; Mesenchymal stem cells; Meta-analysis; Rodent models.