Extracellular Vesicles in Regeneration and Rehabilitation Recovery after Stroke

Simple Summary Patients that survive after a stroke event may present disabilities that can persist for a long time or permanently after it. Clinical intervention with pharmacological and rehabilitation therapies must follow the correct timing and dosing to guarantee optimal recovery of the patients. Extracellular vesicles are nanometric cell products that can be detected in body fluids such as blood and urine; their use as biomarkers for the personalization of stroke therapy and rehabilitation (rehabilomics) might help clinicians and patients to reach the optimal recovery and ameliorate patient quality of life. Moreover, extracellular vesicles released by cells such as stem cells or other human cells are under investigation for their possible regenerative role that could be coupled to standard therapies to stimulate brain remodeling and ameliorate the recovery after stroke. In this review we describe some of the most recent advancements in the field and discuss the potentialities of extracellular vesicles in brain regeneration and rehabilitation after stroke. Patients that survive after a stroke event may present disabilities that can persist for a long time or permanently after it. If stroke prevention fails, the prompt and combinatorial intervention with pharmacological and rehabilitation therapy is pivotal for the optimal recovery of patients and the reduction of disabilities. In the present review, we summarize some key features of the complex events that occur in the brain during and after the stroke event, with a special focus on extracellular vesicles (EVs) and their role as both carriers of biomarkers and potential therapeutics. EVs have already demonstrated their ability to be used for diagnostic purposes for multiple brain disorders and could represent valuable tools to track the regenerative and inflammatory processes occurring in the injured brain after stroke. Last, but not least, the use of artificial or stem cell-derived EVs were proved to be effective in stimulating brain remodeling and ameliorating recovery after stroke. Still, effective biomarkers of recovery are needed to design robust trials for the validation of innovative therapeutic strategies, such as regenerative rehabilitation approaches.

Automated summary

Survivors of stroke may suffer long-term or permanent disabilities. Proper timing and dosing of pharmacological and rehabilitation interventions are crucial for optimal recovery. Extracellular vesicles have the potential to be used as biomarkers for stroke therapy personalization and as possible therapeutics for brain regeneration and rehabilitation after stroke.