High-efficiency extracellular-vesicle-engineering by silicate-bioceramics-activating endothelial progenitor cells for myocardial infarction treatment in male mice

Extracellular vesicles have shown good potential in disease treatments, including those of ischemic injury such as myocardial infarction. However, the efficient production of highly active extracellular vesicles is one of the critical limitations for their clinical applications. Here, we demonstrate a biomaterial-based approach to prepare high amounts of extracellular vesicles with high bioactivity from endothelial progenitor cells (EPCs) by stimulation with silicate ions derived from bioactive ceramics. We further show that highly active extracellular vesicles containing hydrogel microspheres are highly effective in the treatment of myocardial infarction in male mice by significantly enhancing angiogenesis. This therapeutic effect is attributed to significantly enhanced revascularization by the high content of miR-126a-3p and angiogenic factors such as VEGF and SDF-1, CXCR4 and eNOS, which not only activate endothelial cells but also recruit EPCs from the circulatory system.