The roles of exosomes in non-obstructive azoospermia: research advances on spermatogenesis recovery mechanism
10.12483/j.issn.1009-8291.2026.05.016
- VernacularTitle:不同来源外泌体在非梗阻性无精子症中介导精子发生恢复的机制及研究现状
- Author:
Zuoxi LUO
1
;
Li WANG
1
;
Jinli LUO
1
;
Li SHI
1
;
Lina WANG
1
;
Guangmei XIE
1
Author Information
1. The Second Department of Reproductive Medicine Center, Gansu Maternal and Child Health Hospital (Gansu Provincial Central Hospital), Lanzhou 730000, China
- Publication Type:Journal Article
- Keywords:
exosomes;
non-obstructive azoospermia;
obstructive azoospermia;
mesenchymal stroma/stem cells;
spermatogenesis;
microscopic testicular dissection for sperm extraction
- From:
Journal of Modern Urology
2026;31(5):489-494
- CountryChina
- Language:Chinese
-
Abstract:
Diagnostic and therapeutic approaches for non-obstructive azoospermia (NOA) remain limited in current clinical practice, urgently requiring new assistive technologies to advance diagnosis and treatment. As a crucial medium for intercellular communication, exosomes show broad potential in the treatment and diagnosis of NOA. This review summarizes research progress on exosomes from multiple sources. Firstly, mesenchymal stem cell-derived exosomes (e.g., from bone marrow, urine, umbilical cord, adipose tissue) promote spermatogenesis recovery by enhancing spermatogenic cell proliferation, regulating relevant gene expression, supplying growth factors, and providing antioxidant stress protection. Secondly, cell-derived exosomes exert effects by modulating the spermatogonial stem cell microenvironment (e.g., upregulating GFRα1 expression) and directly communicating with germ cells. Thirdly, amniotic fluid-derived exosomes increase spermatogenic cell numbers and upregulate expression of spermatogenesis-related genes such as DAZL and VASA. Furthermore, molecules carried by exosomes—such as miRNAs (e.g., miR-31-5p, miR-26a-5p) and transfer RNA-derived fragments—hold potential diagnostic value in distinguishing non-obstructive from obstructive azoospermia and predicting micro-TESE success rates. This paper aims to provide theoretical basis and research directions for the clinical application of exosomes in NOA.
