Table 3.

Cardioprotection by cardiac-, plasma- and stem-cell-derived exosomes

Source of exosomes	Protection observed	Mechanism	Reference
Cardiac endothelial cells	Improved ejection fraction in mice after MI	Delivery of miR-126 and miR-210 to CPCs, activating prosurvival kinases and inducing a glycolytic switch	[48]
Human or rat plasma	Cardioprotection	Exosomal HSP70 activating MAPK/ERK1/2 signalling via TLR4	[10]
CD34+ve haematopoietic stem cells	Angiogenic activity both in vitro and in vivo	Not determined	[44]
Embryonic stem cells (ESCs)	Enhanced neovascularization, cardiomyocyte survival, and reduced fibrosis post MI	delivery of miR-294 to c-kit+ve cardiac progenitor cells	[46]
Cardiac progenitor cells (CPCs)	Stimulate the migration of endothelial cells in vitro	Matrix metalloproteinases	[49]
Cardiac progenitor cells (CPCs)	Reduced apoptosis, enhanced angiogenesis, improved ejection fraction in rat MI	Potentially via delivery of miR-210, miR-132, and miR-146a-3p	[47]
Cardiospheres (CSp-EMVs)	Primed fibroblasts, which stimulated angiogenesis and cardioprotection when injected in MI	Increased secretion of the SDF-1α and VEGF	[52]
Cardiosphere-derived cells (CDCs)	Improved cardiac function in murine MI inhibiting apoptosis and promoting proliferation of cardiomyocytes, while enhancing angiogenesis	Potentially via delivery of miR-146a	[50]
Cardiosphere-derived cells (CDCs)	Decrease apoptosis and fibrosis and improved function in a doxorubicin-induced cardiomyopathy	Not determined	[51]
Mesenchymal stem cells (MSCs)	Reduced infarct size and improved recovery in a mouse MI	Akt and GSK-3β signalling pathways	[54–56]