Therapeutic Potential of Neural Rosette Stem Cell-Derived Small Extracellular Vesicles in the Management of Brain Edema

Small extracellular vesicles (sEVs) derived from neural stem cells (NSCs) have gained significant interest for their potential roles in neuroprotection, brain edema management, and the preservation of blood-brain barrier (BBB) integrity. These nanoscale particles facilitate intercellular communication and carry a diverse array of bioactive molecules, including proteins and RNAs, which influence various neurobiological processes. The composition of their cargo depends on the parental cell type, affecting their interactions with recipient cells. In this study, we characterized the cargo of sEVs derived from neural rosette stem cells (NRSCs) at both transcriptomic and proteomic levels and compared it to sEVs derived from cardiomyocyte progenitor cells (CMPCs) and human pluripotent stem cells (hPSCs). Furthermore, we assessed the therapeutic effects of NRSC-derived sEVs in a rat model of transient middle cerebral artery occlusion (tMCAO) to investigate neuronal injury and the progression of brain edema. Our proteomic and miRNA analyses revealed that the sEVs from NRSCs, CMPCs, and hPSCs possess distinct cargo compositions. In an in vitro neuronal ischemia model, NRSC-derived sEVs significantly enhanced cell viability, while in an endothelial model, they expedited the restoration of cell barrier integrity. Furthermore, the in vivo studies utilizing the rat model of tMCAO showed that intravenous administration of NRSC-derived sEVs at 3, 24 and 48 hours after reperfusion resulted in a significantly faster resolution of brain edema. These findings underscore the influence of the parental cell type on sEV composition and highlight the therapeutic potential of NRSC-derived sEVs in treating brain edema, paving the way for novel therapeutic strategies.