外泌体在眼底疾病发病及治疗中的作用

Role of exosomes in the pathogenesis and treatment of fundus diseases

外泌体是细胞内的多囊泡体通过与细胞质膜融合后主动分泌到细胞外的小囊泡。外泌体内含有多种活性物质,其在细胞间通讯、疾病进展及作为生物标记物方面的作用已渐被眼底疾病的学者关注。研究显示外泌体参与了湿性年龄相关性黄斑变性病理过程,而间充质干细胞外泌体能够降低湿性年龄相关性黄斑变性患者的血管内皮生长因子转录和翻译;在大鼠糖尿病性视网膜病变血浆中研究发现含有IgG的外泌体可激活视网膜内的经典补体途径促进内皮损伤,应用含有miR-126间充质干细胞衍生的外泌体可限制内皮细胞损伤;在缺血性视网膜病变研究中骨髓间充质干细胞的外泌体可使缺血模型鼠视网膜功能恢复;玻璃体切除联合人脐带组织分离的间充质干细胞外泌体填塞对黄斑裂孔具有辅助治疗作用;视网膜脱离患者使用间充质干细胞分泌的外泌体可抑制光感受器细胞的凋亡;在葡萄膜黑色素瘤患者中外泌体标记物检测有希望成为葡萄膜黑色素瘤的早期诊断手段;在早产儿视网膜病变中小胶质细胞分泌的外泌体具有保护作用等。对外泌体系统的了解及其与眼底疾病中的信号传递机制及疾病转归过程的认识,对优化眼底疾病防治具有重要意义。

Exosomes are small vesicles secreted into the extracellular cells after the fusion of intracellular polycystic bodies and cytoplasmic membranes.Exosomes contain a variety of active substances,and their roles in intercellular communication,disease progression or as biomarkers have been gradually concerned by researchers of fundus diseases.Studies have shown that exosome is involved in the pathological process of wet age-related macular degeneration(wAMD),while mesenchymal stem cell exosomes reduce the transcription and translation of vascular endothelial growth factor(VEGF)in wAMD.In rat diabetic retinopathy,IgG-containing exosomes in plasma activate the classical complement pathway in the retina to promote endothelial injury;while mesenchymal stem cell derived exosomes containing miR-126 can limit endothelial cell injury.In ischemic retinopathy,exosomes of bone marrow mesenchymal stem cells restore retinal function in ischemic mice.Studies on patients with macular hole showed that mesenchymal stem cell exosomes isolated from human umbilical cord tissue combined with vitrectomy had therapeutic effect on macular hole.Exosomes secreted by mesenchymal stem cells in patients with retinal detachment can inhibit the apoptosis of photoreceptor cells.Detection of exosome markers in patients with uveal melanoma is expected to be an early diagnosis method for uveal melanoma.Exosomes secreted by microglia have protective effect on retinoprthy of prematurity.With the understanding of exosome system and its related signal transmission mechanism and disease outcome process in fundus diseases,it is of great significance to optimize treatment and prevention of fundus diseases.