Vesículas extracelulares derivadas de células madre mesenquimales. Mesenchymal stem cell-derived extracellular vesicles.El potencial terapéutico en el daño pulmonar agudo. Therapeutic pontential in acute lung injury

Abstract

Acute respiratory distress syndrome (ARDS) is a pathology characterized by pulmonary vascular dysfunction, inflammatory phenomena, coagulation disorders and pulmonary oedema leading to alveolar collapse and severe arterial hypoxaemia. Although protective ventilatory and haemodynamic support strategies have improved prognosis, the mortality associated remains high and the discovery of new effective treatments would have a major impact on patient survival. Mesenchymal stem cells (MSCs) have been proposed as a possible therapy in different pathologies due to their low immunogenicity and their ability to repair damage (due to their anti-inflammatory, anti-apoptotic, proangiogenic and anti-fibrotic properties). However, this therapeutic capacity has been shown to be due to the involvement of paracrine mechanisms, such as the release of extracellular vesicles (EVs). Several studies have demonstrated the therapeutic potential of extracellular vesicles in different models of acute lung injury and pulmonary hypertension. In addition, MSCs have been shown to exhibit different responses depending on the environment in which they are found, which has led to a growing interest in the search for strategies to increase their beneficial effects. Among the preconditioning strategies, hypoxia and exposure to TLR3 agonists have been shown to enhance the immunomodulatory and angiogenic capacity of EVs...