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Exploring the Role of Exosomes in Diabetic Neuropathy: From Molecular Mechanisms to Therapeutic Potential Publisher Pubmed



Tajabadi Z1 ; Dadkhah PA2 ; Gholami Chahkand MS3 ; Esmaeilpour Moallem F3 ; Karimi MA4 ; Aminisalehi E5 ; Karimi M6
Authors
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Authors Affiliations
  1. 1. Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
  4. 4. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  6. 6. Faculty of Medicine, Bogomolets National Medical University (NMU), Kyiv, Ukraine

Source: Biomedicine and Pharmacotherapy Published:2025


Abstract

Diabetic neuropathy (DN) is a debilitating complication of diabetes mellitus (DM), characterized by progressive neuronal damage, sensory dysfunction, and impaired quality of life. Recent advances in exosome research have elucidated their crucial role in DN's pathogenesis, diagnosis, and treatment. Exosomes—nanoscale extracellular vesicles—function as vehicles for molecular cargo, including microRNAs (miRNAs), proteins, and lipids, which mediate intercellular communication and regulate key biological processes. Pathologically, hyperglycemia and hyperlipidemia induce the release of exosomes enriched with pathogenic miRNAs, such as miR-130a and miR-20b-3p, which disrupt neuronal function, axonal regeneration, and inflammatory pathways. Conversely, diagnostic studies highlight the utility of exosomal biomarkers like miR-7 and miR-221 in the early detection and monitoring of DN. Therapeutically, Schwann cell-derived and mesenchymal stromal cell (MSC)-derived exosomes demonstrate neuroprotective and reparative effects by enhancing mitochondrial function, modulating inflammation, and promoting axonal repair. Emerging approaches, including engineered exosomes and miRNA-enriched vesicles, further expand their therapeutic potential. Despite these advances, challenges such as standardization, large-scale production, and clinical validation remain in translating these findings into clinical practice. This review underscores the multifaceted roles of exosomes in DN and highlights their potential as innovative tools for precision diagnostics and targeted therapies, paving the way for future research and clinical applications. © 2025 The Authors
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