Exosomal non-coding RNA biomarkers in traumatic brain injury.

Traumatic brain injury (TBI) poses a significant global health challenge, leading to high mortality and morbidity rates. Despite extensive research, effective diagnostic and therapeutic strategies remain limited. This review explores the emerging roles of exosomal non-coding RNAs (ncRNAs) as biomarkers and therapeutic agents in TBI. Exosomes, small extracellular vesicles secreted by various cell types, facilitate intercellular communication and carry diverse ncRNAs that modulate gene expression and cellular functions. The pathogenesis of TBI involves complex inflammatory cascades, in which exosomal ncRNAs play pivotal roles in neuroinflammation, neuronal apoptosis, and secondary injury mechanisms. Key ncRNAs, including long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been identified as potential biomarkers for diagnosing TBI and predicting outcomes. Additionally, exosomal ncRNAs derived from mesenchymal stem cells (MSCs) show promise in promoting neuroprotection and enhancing recovery through various mechanisms. The review highlights the potential of exosomal ncRNAs in addressing critical unmet needs in TBI management, emphasizing their stability, accessibility, and relevance to disease pathophysiology. However, challenges in standardization, validation, and regulatory pathways must be addressed to facilitate their clinical application. This comprehensive examination underscores the transformative potential of exosomal ncRNAs in TBI diagnosis and treatment, paving the way for future research and clinical innovations.