Theranostics 2021; 11(12):5986-6005. doi:10.7150/thno.58632 This issue

Research Paper

Antioxidant activity of mesenchymal stem cell-derived extracellular vesicles restores hippocampal neurons following seizure damage

Qiang Luo1*, Panpan Xian1*, Tian Wang1*, Shengxi Wu2, Tangna Sun2, Wenting Wang2, Bo Wang1, Hao Yang1, Yanping Yang1, Han Wang3, Weiping Liu3, Qianfa Long1,4✉

1. Mini-invasive Neurosurgery and Translational Medical Center, Xi'an Central Hospital, Xi'an Jiaotong University. No. 161, West 5th Road, Xincheng District, Xi'an, 710003, P. R. China.
2. Department of Neurobiology, School of Basic Medicine, Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, P. R. China.
3. Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, No. 127 Changle West Road, Xi'an, 710032, P. R. China.
4. College of Medicine, Yan'an University, Yongxiang Road, Baota District, Yan'an, 716000, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Luo Q, Xian P, Wang T, Wu S, Sun T, Wang W, Wang B, Yang H, Yang Y, Wang H, Liu W, Long Q. Antioxidant activity of mesenchymal stem cell-derived extracellular vesicles restores hippocampal neurons following seizure damage. Theranostics 2021; 11(12):5986-6005. doi:10.7150/thno.58632. Available from

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Graphic abstract

Oxidative stress is a critical event in neuronal damage following seizures. Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) have been shown to be promising nanotherapeutic agents in neurological disorders. However, the mechanism underlying MSC-EVs therapeutic efficacy for oxidative stress-induced neuronal damage remains poorly understood.

Methods: We investigated the antioxidant and restoration activities of MSC-EVs on hippocampal neurons in response to H2O2 stimulation in vitro and seizures in vivo. We also explored the potential underlying mechanism by injecting adeno-associated virus (AAV)-nuclear factor erythroid-derived 2, like 2 (Nrf2), a key antioxidant mediator, in animal models.

Results: MSC-EVs were enriched in antioxidant miRNAs and exhibited remarkable antioxidant activity evident by increased ferric ion-reducing antioxidant ability, catalase, superoxide dismutase, and glutathione peroxidase activities and decreased reactive oxygen species (ROS) generation, DNA/lipid/protein oxidation, and stress-associated molecular patterns in cultured cells and mouse models. Notably, EV administration exerted restorative effects on the hippocampal neuronal structure and associated functional impairments, including dendritic spine alterations, electrophysiological disturbances, calcium transients, mitochondrial changes, and cognitive decline after oxidative stress in vitro or in vivo. Mechanistically, we found that the Nrf2 signaling pathway was involved in the restorative effect of EV therapy against oxidative neuronal damage, while AAV-Nrf2 injection attenuated the antioxidant activity of MSC-EVs on the seizure-induced hippocampal injury.

Conclusions: We have shown that MSC-EVs facilitate the reconstruction of hippocampal neurons associated with the Nrf2 defense system in response to oxidative insults. Our study highlights the clinical value of EV-therapy in neurological disorders such as seizures.

Keywords: extracellular vesicles, hippocampal neuron, mesenchymal stem cells, oxidative stress, seizures