Cell therapy of radiation injury in experimental models

Considering their significant histophysiological effects, stem cells and extracellular vesicles are a promising approach in both military and civilian medicine for the treatment of acute radiation syndrome. This review aimed to summarize experimental data on the potential use of stem cells and their extracellular vesicles in radiation injuries. A systematic review was conducted to evaluate the efficacy of transplanting various types of cells (mesenchymal, hematopoietic, and neural stem cells, as well as progenitor cells) and extracellular vesicles in experimental radiation injury. The analysis included 13 Russian-language and 96 international publications from January 2002 to April 2024. The review discusses the cellular effects observed in experimental models of radiation injuries and local radiation exposure at doses ranging from 1 Gy to 110 Gy. It summarizes the therapeutic effects of stem cells and extracellular vesicles, particularly their influence on stem cell niches. The primary mechanism behind this therapy is a paracrine effect mediated by extracellular vesicles. This paracrine action enhances the survival of endogenous stem cells while reducing their apoptosis. This cell therapy has been shown to increase survival of animals with bone marrow and intestine radiation injuries and accelerate recovery from local radiation injuries. In recent decades, mesenchymal stromal cell transplantation has been the primary focus of research owing to its efficacy in hematological, intestinal, and cerebral acute radiation syndromes. Its therapeutic action is mediated through the suppression of inflammation and modulation of the microenvironment of endogenous stem cells, thereby improving their survival and reducing apoptosis.