Mesenchymal Stem Cell-Derived Exosomes Ameliorate Gentamicin-Induced Vestibular Hair Cell Injury by Regulating the SNARE Pathway and Enhancing Autophagy

This study explores the protective effects of umbilical cord mesenchymal stem cell-derived exosomes on gentamicin-induced vestibular hair cell injury in 20 male Sprague-Dawley rats. The exosomes were found to ameliorate hair cell injury by regulating the SNARE pathway and enhancing autophagy, suggesting a potential therapeutic approach for gentamicin-induced ototoxicity. Exosomes improved vestibular dysfunction, enhanced locomotor activity, reduced balance dysfunction, alleviated hearing loss at high frequencies, and increased hair cell counts in the utricular and saccular maculae and crista ampullaris. They showed a slightly superior protective effect on hearing compared to dexamethasone, although not statistically significant. The study highlights exosomes' potential in mitigating vestibular and auditory impairments by inhibiting Caspase-3-mediated apoptosis and enhancing autophagy, offering a promising therapeutic approach for inner ear injuries.