{
  "abstract": "Ischemic stroke (IS) is a common cause of physical disability and death worldwide. Although it has been indicated that mesenchymal stem cells (MSCs) can treat IS through mechanisms such as immunomodulation, angiogenesis and neuroprotection, their clinical application is limited by inherent drawbacks, such as immune rejection risk and tumorigenic potential. Notably, MSC-derived exosomes (MSC-Exos) possess advantages, such as a smaller volume, low immunogenicity and low tumorigenicity, enabling therapeutic effects similar to those of the parent cells. Furthermore, MSC-Exos can carry various bioactive substances and cross the blood-brain barrier (BBB), thus indicating their potential in the diagnosis, treatment and prognostic assessment of IS. The present review comprehensively elaborates on the principles by which MSC-Exos may treat IS through mechanisms such as inhibiting inflammatory responses, suppressing apoptosis, promoting angiogenesis, regulating ferroptosis and maintaining BBB integrity. However, the therapeutic efficacy of MSC-Exo monotherapy is restricted by its low brain bioavailability, short lesion retention time, insufficient in vivo stability and inability to remain at the lesion site for an extended period of time to exert its effect. Furthermore, the review summarizes the recent optimization strategies involving the combination of MSC-Exos with microRNAs, traditional Chinese medicine, hydrogels, exosome pretreatment and electroacupuncture to enhance the efficacy of MSC-Exo therapy for IS, and systematically reviews their synergistic therapeutic mechanisms. In addition, the current status of clinical translation, technical breakthrough obstacles and future development directions for MSC-Exo combination therapies in neurological diseases is outlined, providing a theoretical reference for innovative treatments of IS.",
  "abstract_shown": true,
  "affiliations": [
    "Center for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "School of Rehabilitation and Exercise Health, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "Department of Rehabilitation Medicine, Siyang Hospital, Suqian, Jiangsu 223700, P.R. China",
    "School of Pharmacy, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "Ganzhou Key Laboratory of Stem Cell and Regenerative Medicine, Ganzhou, Jiangxi 341000, P.R. China",
    "Jiangxi Provincial Key Laboratory of Tissue Engineering, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "First Clinical College, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "Department of Clinical Medicine Research Center, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China",
    "JXHC Key Laboratory of Stem Cells and Emerging Biotechnology, Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Yan Xu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Xiaolei Zhou"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Wenhui Zeng"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Jiabing Wang"
    },
    {
      "affs": [
        0,
        4,
        5,
        6
      ],
      "name": "Lin Zhou"
    },
    {
      "affs": [
        0,
        4,
        5,
        6
      ],
      "name": "Lincai Li"
    },
    {
      "affs": [
        0,
        4,
        5,
        6
      ],
      "name": "Zhengwei Zou"
    },
    {
      "affs": [
        7
      ],
      "name": "Cixiang Chen"
    },
    {
      "affs": [
        7
      ],
      "name": "Yichi Zhang"
    },
    {
      "affs": [
        8
      ],
      "name": "Zhengyi He"
    },
    {
      "affs": [
        0,
        4,
        5,
        6,
        9
      ],
      "name": "Junsong Ye"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b02401y11yjt2.bib",
  "cited_by": 0,
  "doi": "10.3892/ijmm.2026.6016",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712493/",
  "id": "b02401y11yjt2",
  "issns": [
    "1107-3756",
    "1791-244X"
  ],
  "landing_url": "https://doi.org/10.3892/ijmm.2026.6016",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "1312|Extracellular vesicles in disease"
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  ],
  "openalex": "W7221809746",
  "pdf_url": "http://www.spandidos-publications.com/10.3892/ijmm.2026.6016/download",
  "pmcid": "PMC13712493",
  "pmid": "42885286",
  "published": "2026-10-14",
  "publisher": "Spandidos Publications",
  "ris": "https://research.draconitic.com/paper/b02401y11yjt2.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:23:03Z",
      "native_id": "PMC13712493",
      "source": "pmc",
      "url": "https://doi.org/10.3892/ijmm.2026.6016"
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  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Extracellular vesicles in disease",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Multiple strategies to improve the therapeutic efficacy of mesenchymal stem cell-derived exosome transplantation in ischemic stroke (Review)",
  "title_text": "Multiple strategies to improve the therapeutic efficacy of mesenchymal stem cell-derived exosome transplantation in ischemic stroke (Review)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:03Z",
  "url": "https://research.draconitic.com/paper/b02401y11yjt2",
  "venue": "International Journal of Molecular Medicine",
  "versions": []
}