In murine TBI models, CEC-Exos alleviated cerebral glucose hypometabolism, reduced lesion volume and neuronal apoptosis, and improved neurological recovery with these effects abolished by miR-16-5p depletion.
Abstract
Traumatic brain injury (TBI) triggers a severe cerebral energy crisis causing irreversible neurodegeneration, with no effective targeted therapies available. Traditional TBI research neglects the secretory function of cerebral endothelial cells (CECs), and this study explored whether CEC-derived exosomes (CEC-Exos) exert SDF-1α/CXCR4-mediated lesion homing and rescue TBI-induced energy dysfunction, as well as the underlying mechanism. CECs endogenously express CXCR4, and TBI upregulates SDF-1α in the injured microenvironment; CEC-Exos inherit this SDF-1α/CXCR4-mediated homing property, which is attenuated by siCXCR4 knockdown. Multi-omics identified miR-16-5p as the key exosomal effector that orchestrates cerebral metabolic rewiring, redirecting glucose metabolism from glycolysis to mitochondrial oxidative phosphorylation, reversing the TBI-induced energy crisis and restoring ATP production. In murine TBI models, CEC-Exos alleviated cerebral glucose hypometabolism, reduced lesion volume and neuronal apoptosis, and improved neurological recovery with these effects abolished by miR-16-5p depletion. Collectively, CEC-Exos serve as endogenous targeted therapeutic agents for TBI via SDF-1α/CXCR4-mediated homing and miR-16-5p-dependent metabolic regulation. We also propose a novel neurovascular coupling mechanism where CEC-Exos act as “endogenous neuro-metabolic couplers” to improve neuronal energy metabolism, offering a new TBI treatment strategy.
BACKGROUND
Ischemic stroke is a leading cause of disability and mortality worldwide, with limited therapeutic options for long-term recovery. Bone marrow-derived mesenchymal stem cell (BMSC)-derived exosomes have emerged as a promising cell-free therapy, but their efficacy is often constrained by poor homing efficiency...
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Ischemic stroke is a leading cause of mortality and long-term disability worldwide, with complex pathophysiological mechanisms and limited therapeutic options. The identification of key molecular targets that can effectively modulate the multifaceted pathological and reparative processes underlying ischemic stroke is u...
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This Review summarizes the therapeutic landscape of stem cell interventions for TBI, encompassing mesenchymal stem cells, neural stem cells, and cell-free derivatives including extracellular vesicles (EVs) and exosomes, and examines recent advances in therapeutic engineering.
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It is demonstrated that AM-derived exosomes represent a promising therapeutic approach for TBI by suppressing pyroptosis and facilitating functional recovery through inhibition of the SERPINE1/HIF-1α/NLRP3 axis.
Traumatic brain injury (TBI) is a major cause of long-term neurological disability, and repeated mild TBI (rmTBI) is increasingly linked to chronic neurodegeneration. Clinical evidence suggests that rmTBI creates a prolonged window of vulnerability to further injury. However, the astrocyte-intrinsic mechanisms that c...
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