外泌体对睾丸微环境调控机制研究及应用进展

外泌体（exsomes）是一类具有生物活性的双层脂质组成的小囊泡，可携带不同类型的信息物质与受体细胞结合，通过信息传递与物质交换，促发受体细胞的表型发生变化。本文总结了在睾丸微环境中，外泌体通过调节细胞因子促进睾丸微环境中细胞增殖、调节细胞免疫维持睾丸免疫环境、调节氧化应激修复受体细胞功能、调节细胞自噬改善生精能力、调节细胞凋亡改善精子发生、调节细胞因子影响睾酮分泌等机制维持睾丸微环境稳态，并对外泌体在男科相关疾病预防、诊断、治疗中的作用进行归纳，外泌体在男性不育、勃起功能障碍、精索静脉曲张、性腺功能减退、前列腺癌等疾病诊疗中具备明显优势。外泌体作为一种新兴的应用物质，随着外泌体工程和提取工艺的不断优化，以及相关机制研究的不断深入，外泌体在男科疾病中的临床运用成为可能，有望成为治疗男科疾病的新手段。

Research on The Regulation Mechanism of Exosomes on Testicular Microenvironment and Its Application Progress

Exosomes are a class of small vesicles composed of bioactive bilayer lipids, which can carry different types of information substances and bind to recipient cells. Through information transmission and substance exchange, exosomes can induce changes in the phenotype of recipient cells. This article summarized the various mechanisms of exosomes in maintaining testicular microenvironment homeostasis, such as promoting cell proliferation in the testicular microenvironment by regulating cytokines, regulating cellular immunity to maintain the testis immune environment, regulating oxidative stress to repair the recipient cell function, regulating autophagy to improve spermatogenesis, regulating cell apoptosis to improve spermatogenesis, and regulating cytokines to influence testosterone secretion. Then, the preventive, diagnostic and therapeutic effects of exosomes in andrology diseases were highlighted. Exosomes have obvious advantages in the diagnosis and treatment of infertility, erectile dysfunction, varicocele, hypogonadism, prostate cancer and other diseases. With the continuous advance in exosome engineering, exosome extraction, as well as research on the related mechanisms, the clinical application of exosomes, as an emerging applied substance, is expected to become a new treatment approach for andrological diseases.