Stroke Rehabilitation

Title:

Intermittent hypoxic training – derived exosomes in stroke rehabilitation

 

Abstract:

Ischemic stroke is the fourth leading cause of adult disability in the US, and it is a huge social burden all over the world. However, the efficient treatment of ischemic stroke is not available. An apparent reason for failing to find or develop an intervention for ischemic stroke is contributed to the tight blood–brain barrier (BBB). The unique characteristics of exosomes that can traverse BBB have been highlighted among researchers investigating interventions for ischemic stroke conditions. Additionally, intermittent hypoxic training has been considered a potential intervention in the treatment or rehabilitation process of ischemic stroke patients. In this mini-review, we are going to review the possibility of applying exosomes produced by a subject who does intermittent hypoxic conditioning in a treatment program for ischemic stroke.

 

Conclusion:

The brain, which consumes the most oxygen of any organ, is highly sensitive to damage that may be induced by hypoxia, which is closely related to stroke and other brain diseases. However, nIHT has shown promising effects to mitigate harmful effects and enhance protective responses to protect the brain from ischemic injury. As an important intercellular player in neurovascular communication, the exosome mediates cerebral injury by transferring protein and RNA cargoes.

In conclusion, novel evidence suggests exosomes that have undergone hypoxic preconditioning have neuroprotective properties, but the therapeutic effects of intermittent hypoxia have not yet been explored. Published journals investigating exosomes that have been pre-conditioned with IHT are very limited. Nevertheless, exploring the potential benefits of combining IHT and exosome therapy would be of great value, which has been noted separately as successful. In contrast, several areas allow improvement of current strategies for disease treatment using exosomes. Current isolation and purification techniques are time-consuming and have low yield rates (Stranska et al., 2018). Challenges associated with the rapid biological clearance rate of exosomes post-local administration must be addressed to maximize therapeutic efficacy while minimizing unwanted effects.

Furthermore, IHT can elicit different exosome responses depending on their cell lineage and the hypoxic exposure’s duration, frequency, and intensity.

Overall, the protective mechanisms underlying intermittent hypoxic conditioning and utilizing exosomes are complex and diverse and have yet to be fully explored. Despite this, current evidence suggests this may hold great potential in stroke rehabilitation in the future.

 

Full study can be found HERE