人脐带间充质干细胞外泌体(hUCMSC-EXOs)在治疗高原鼻黏膜损伤的临床疗效及其相关文献回顾

Clinical Efficacy of Human Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes (hUCMSC-EXOs) in the Treatment of High-Altitude-Related Nasal Mucosal Injury and a Review of the Relevant Literature

摘要:

目的 探讨人脐带间充质干细胞外泌体(hUCMSC-EXOs)雾化吸入治疗亚高原地区鼻黏膜损伤患者的临床疗效,并结合相关文献综述外泌体在鼻部疾病中的作用机制与应用价值。方法 选取2024.01～2025.10于联勤保障部队第九四〇医院耳鼻咽喉头颈外科门诊就诊、海拔＞1500 m亚高原环境所致鼻黏膜糜烂患者共50例。所有受试者予以hUCMSC-EXOs雾化干预,连续给药3 d为单次治疗单元,每月开展1次治疗,共计3次为完整疗程。分别于疗程结束后1周、4周、8周及12周开展随访,借助鼻内镜评估黏膜修复状态,对比治疗前后患者鼻部症状VAS评分与鼻内镜黏膜评分,并开展统计学分析以综合评判疗效。结果 50例患者治疗前鼻部症状VAS评分为(5.36±2.34)分,治疗后降至(1.62±1.78)分；治疗前鼻内镜评分为(5.92±2.07)分,治疗后为(1.30±1.49)分,两组指标治疗前后对比差异均有统计学意义(P＜0.05)。结论 hUCMSC-EXOs雾化吸入方案操作简便、依从性好,能够有效修复亚高原受损鼻黏膜、重建鼻腔黏膜生理功能,可作为高原鼻黏膜损伤优选治疗方案,具备较高临床推广价值。

Abstract:

Objective: To investigate the clinical efficacy of nebulized inhalation of human umbilical cord mesenchymal stem cell-derived exosomes (hUCMSC-EXOs) in patients with nasal mucosal injury in sub-high-altitude areas, and to review the mechanisms of action and potential applications of exosomes in nasal diseases based on relevant literature.Methods: A total of 50 patients with nasal mucosal erosion caused by exposure to a sub-high-altitude environment (>1500 m) who visited the Department of Otorhinolaryngology–Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Force, from January 2024 to October 2025 were enrolled. All patients received nebulized hUCMSC-EXOs. Three consecutive days of administration constituted one treatment cycle, which was repeated once monthly for a total of three cycles. Follow-up assessments were performed at 1, 4, 8, and 12 weeks after completion of treatment. Nasal endoscopy was used to evaluate mucosal repair. Nasal symptom visual analog scale (VAS) scores and nasal endoscopic mucosal scores before and after treatment were compared, and statistical analyses were performed to comprehensively evaluate therapeutic efficacy.Results: The mean nasal symptom VAS score decreased from 5.36 ± 2.34 before treatment to 1.62 ± 1.78 after treatment. The mean nasal endoscopic score decreased from 5.92 ± 2.07 before treatment to 1.30 ± 1.49 after treatment. Both outcome measures showed statistically significant improvements after treatment compared with baseline (P < 0.05).Conclusion: Nebulized inhalation of hUCMSC-EXOs is simple to administer and is associated with good treatment adherence. It can effectively promote repair of damaged nasal mucosa in sub-high-altitude environments and help restore normal physiological function of the nasal mucosa. hUCMSC-EXOs may therefore represent a promising therapeutic option for high-altitude-related nasal mucosal injury, with considerable potential for clinical application.