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      The therapeutic potential of stem cell-derived exosomes in the ulcerative colitis and colorectal cancer

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          Abstract

          Background

          Mesenchymal stem cells (MSCs) therapy is a novel treatment strategy for cancer and a wide range of diseases with an excessive immune response such as ulcerative colitis (UC), due to its powerful immunomodulatory properties and its capacity for tissue regeneration and repair. One of the promising therapeutic options can focus on MSC-secreted exosomes (MSC-Exo), which have been identified as a type of paracrine interaction. In light of a wide variety of recent experimental studies, the present review aims to seek the recent research advances of therapies based on the MSC-Exo for treating UC and colorectal cancer (CRC).

          Methods

          A systematic literature search in MEDLINE, Scopus, and Google Scholar was performed from inception to December 2021 using the terms [(“colorectal cancer” OR “bowel cancer” OR “colon cancer” OR “rectal cancer”) AND (exosome) AND (stem cell) AND (“inflammatory bowel disease” OR “Crohn's disease” OR “colitis”)] in titles and abstracts.

          Findings

          Exosomes derived from various sources of MSCs, including human umbilical cord-derived MSCs (hUC-MSCs), human adipose-derived MSCs (hAD-MSCs), human bone marrow-derived MSCs (hBM-MSCs), and olfactory ecto-MSCs (OE-MSCs), have shown the protective role against UC and CRC. Exosomes from hUC-MSCs, hBM-MSCs, AD-MSCs, and OE-MSCs have been found to ameliorate the experimental UC through suppressing inflammatory cells including macrophages, Th1/Th17 cells, reducing the expression of proinflammatory cytokines, as well as inducing the anti-inflammatory function of Treg and Th2 cells and enhancing the expression of anti-inflammatory cytokines. In addition, hBM-MSC-Exo and hUC-MSC-Exo containing tumor-suppressive miRs (miR-3940-5p/miR-22-3p/miR‐16‐5p) have been shown to suppress proliferation, migration, and invasion of CRC cells via regulation of RAP2B/PI3K/AKT signaling pathway and ITGA2/ITGA6.

          Key messages

          The MSC-Exo can exert beneficial effects on UC and CRC through two different mechanisms including modulating immune responses and inducing anti-tumor responses, respectively.

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          Most cited references116

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          Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors

          According to GLOBOCAN 2018 data, colorectal cancer (CRC) is the third most deadly and fourth most commonly diagnosed cancer in the world. Nearly 2 million new cases and about 1 million deaths are expected in 2018. CRC incidence has been steadily rising worldwide, especially in developing countries that are adopting the “western” way of life. Obesity, sedentary lifestyle, red meat consumption, alcohol, and tobacco are considered the driving factors behind the growth of CRC. However, recent advances in early detection screenings and treatment options have reduced CRC mortality in developed nations, even in the face of growing incidence. Genetic testing and better family history documentation can enable those with a hereditary predisposition for the neoplasm to take preventive measures. Meanwhile, the general population can reduce their risk by lowering their red meat, alcohol, and tobacco consumption and raising their consumption of fibre, wholesome foods, and certain vitamins and minerals.
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            Global colorectal cancer burden in 2020 and projections to 2040

            • There are estimated 1.93 million new CRC cases diagnosed, and 0.94 million CRC caused deaths in 2020 worldwide. • The global new CRC cases is predicted to reach 3.2 million in 2040. • China and the United States have the highest estimated number of new CRC cases in the next 20 years. • The number of new CRC cases is increased from 0.56 million (2020) to 0.91 million (2040) in China. • The number of new CRC cases is increased from 0.16 million (2020) to 0.21 million (2040) in the United States. As the third most common malignancy and the second most deadly cancer, colorectal cancer (CRC) induces estimated 1.9 million incidence cases and 0.9 million deaths worldwide in 2020. The incidence of CRC is higher in highly developed countries, and it is increasing in middle- and low-income countries due to westernization. Moreover, a rising incidence of early-onset CRC is also emerging. The large number of CRC cases poses a growing global public health challenge. Raising awareness of CRC is important to promote healthy lifestyle choices, novel strategies for CRC management, and implementation of global screening programs, which are critical to reducing CRC morbidity and mortality in the future. CRC is a heterogeneous disease, and its subtype affiliation influences prognosis and therapeutic response. An accurate CRC subtype classification system is of great significance for basic research and clinical outcome. Here, we present the global epidemiology of CRC in 2020 and projections for 2040, review the major CRC subtypes to better understand CRC molecular basis, and summarize current risk factors, prevention, and screening strategies for CRC.
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              A doxorubicin delivery platform using engineered natural membrane vesicle exosomes for targeted tumor therapy.

              Targeted drug delivery vehicles with low immunogenicity and toxicity are needed for cancer therapy. Here we show that exosomes, endogenous nano-sized membrane vesicles secreted by most cell types, can deliver chemotherapeutics such as doxorubicin (Dox) to tumor tissue in BALB/c nude mice. To reduce immunogenicity and toxicity, mouse immature dendritic cells (imDCs) were used for exosome production. Tumor targeting was facilitated by engineering the imDCs to express a well-characterized exosomal membrane protein (Lamp2b) fused to αv integrin-specific iRGD peptide (CRGDKGPDC). Purified exosomes from imDCs were loaded with Dox via electroporation, with an encapsulation efficiency of up to 20%. iRGD exosomes showed highly efficient targeting and Dox delivery to αv integrin-positive breast cancer cells in vitro as demonstrated by confocal imaging and flow cytometry. Intravenously injected targeted exosomes delivered Dox specifically to tumor tissues, leading to inhibition of tumor growth without overt toxicity. Our results suggest that exosomes modified by targeting ligands can be used therapeutically for the delivery of Dox to tumors, thus having great potential value for clinical applications. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                boyiiman1988@163.com
                ausgstudy@163.com
                liuyaping5222491@126.com
                xajdsfy@163.com
                junjunshe1975@sina.com
                Journal
                Stem Cell Res Ther
                Stem Cell Res Ther
                Stem Cell Research & Therapy
                BioMed Central (London )
                1757-6512
                1 April 2022
                1 April 2022
                2022
                : 13
                : 138
                Affiliations
                [1 ]GRID grid.43169.39, ISNI 0000 0001 0599 1243, Center for Gut Microbiome Research, Med-X Institute Centre, , First Affiliated Hospital of Xi’an Jiao Tong University, ; Xi’an, 710061 China
                [2 ]GRID grid.43169.39, ISNI 0000 0001 0599 1243, Department of Talent Highland, , First Affiliated Hospital of Xi’an Jiao Tong University, ; Xi’an, 710061 China
                [3 ]GRID grid.233520.5, ISNI 0000 0004 1761 4404, Department of Digestive Surgery, Xijing Hospital, , Air Force Medical University, ; Xi’an, 710032 China
                [4 ]GRID grid.452438.c, ISNI 0000 0004 1760 8119, Department of Gastroenterology, , First Affiliated Hospital of Xi’an Jiaotong University, ; Xi’an, 710061 China
                [5 ]GRID grid.43169.39, ISNI 0000 0001 0599 1243, Department of General Surgery, , First Affiliated Hospital of Xi’an Jiao Tong University, ; Xi’an, 710061 China
                Author information
                http://orcid.org/0000-0002-4175-4904
                Article
                2811
                10.1186/s13287-022-02811-5
                8973885
                35365226
                53a2a438-3f82-4c3e-bc7b-078accb8d2cf
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 28 January 2022
                : 23 February 2022
                Funding
                Funded by: Project supported by the National Natural Science Foundation of China
                Award ID: 82100554
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002858, China Postdoctoral Science Foundation;
                Award ID: 2019M663748
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2022

                Molecular medicine
                exosome,colorectal cancer,mesenchymal stem cells,ulcerative colitis
                Molecular medicine
                exosome, colorectal cancer, mesenchymal stem cells, ulcerative colitis

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