What type of study is this?

This is a Systematic Review study (also classified as: Quantitative Study).

September 30, 2025Open Access

microRNAs shuttled by mesenchymal stromal cell-derived exosomes in coronary artery disease: A systematic review of preclinical studies

SMSoroush MostafaviIran University of Medical Sciences AAAmin ArastehTabriz University of Medical Sciences SMSeyedeh Mina Mostafavi MontazeriShahid Beheshti University of Medical Sciences

Key Points

The systematic review assesses the role of microRNAs in exosomes derived from mesenchymal stromal cells, indicating their therapeutic potential for coronary artery disease.
Fifty-six preclinical studies were included, with bone marrow-derived mesenchymal stromal cells being the most common source for exosome preparation.
The ultracentrifugation method was mainly used for exosome isolation from MSCs, demonstrating the methodological rigor in the studies reviewed.
MSC-derived exosomal microRNAs exhibited anti-inflammatory, anti-apoptotic, and angiogenic effects, suggesting their capacity to enhance cardiac recovery in injured tissues.

Abstract

Introduction: Coronary artery disease (CAD) is a life-threatening cardiac condition with high morbidity and mortality worldwide. This systematic review article highlighted the therapeutic roles of mesenchymal stromal cells (MSCs)-derived exosomal microRNAs (exo-miRs) in preclinical models of CAD. Methods: A comprehensive search was conducted on PubMed, Web of Science, Scopus, and Google Scholar to identify relevant publications until 04 Apr 2025. The literature review focuses on the origin of MSCs, the technique employed for exosome extraction and identification, the route and frequency of exosomal administration, the mechanisms through which exo-miRs regulate paracrine activity, and their impact on cardiac outcome. Results: After meticulous evaluation, fifty-six studies were deemed eligible for inclusion in this systematic review. Bone marrow-derived MSCs were the most commonly utilized cell type in the preclinical studies. The majority of studies employed the ultracentrifugation method for exosome isolation from MSCs. The administration of exosomes was primarily achieved through a single intramyocardial injection, utilizing a wide range of exosome concentrations (ranging from 0.02-400 μg/μL). Conclusion: The included studies predominantly have reported the anti-inflammatory, anti-apoptotic, angiogenic, antifibrotic, and reparative effects of MSC-exo-miRs, especially under hypoxic conditions. These findings support the capacity of MSC-exo-miRs to regulate the immune system and facilitate cardiac recovery following an injury.

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