Naeimeh Akbari-Gharalari
1 
, Abbas Ebrahimi-Kalan
2,3* 
, Zeinab Aliyari-Serej
4, Hamid Soltani Zangbar
2, Maryam Ghahremani-Nasab
5, Yahya Yahyavi
6, Ayyub Ebrahimi
7, Negar Aghaei
8, Farshad Nezhadshahmohammad
91 Neurophysiology Research Center, Cellular and Molecular Medicine Research Institute, Urmia University of Medical Sciences, Urmia, Iran
2 Department of Neuroscience and Cognition, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
3 Neurosciences Research Centre (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
4 Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
5 Stem Cells and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
6 Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
7 Department of Molecular Biology and Genetic, Faculty of Arts and Sciences, Halic University, Istanbul, Turkey
8 Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
9 Department of Mining Engineering, Faculty of Engineering, Urmia University, Urmia, Iran
Abstract
This review explores the synergistic effects of exosomes and autophagy in mitigating spinal cord injury (SCI) while elucidating the underlying molecular mechanisms. We evaluate current literature on the roles of exosomes and autophagy in SCI, highlighting key findings from both in vitro and in vivo studies. Previous research has demonstrated the contributions of these processes to cellular responses under SCI-related conditions. Additionally, animal models have provided insights into the therapeutic potential of modulating exosome and autophagy pathways. The overview discusses the activation of mTOR signaling and autophagy-related proteins, emphasizing their impacts on inflammation and axonal integrity. We identify a synergistic mechanism in which exosome-mediated cargo delivery and autophagy modulation work together to mitigate the effects of SCI. The regulation of the mTOR pathway and autophagy-related proteins is crucial for reducing inflammation and preserving axonal integrity. These findings underscore the therapeutic potential of targeting exosomes and autophagy for SCI treatment. The collaborative actions of these cellular processes present promising therapeutic avenues for SCI and possibly other neurological disorders. This review underscores the necessity for further studies to unravel the molecular intricacies and to translate these findings into clinical applications for SCI patients.