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. 2021 Sep 28;12(1):521.
doi: 10.1186/s13287-021-02596-z.

Applications, challenges and prospects of mesenchymal stem cell exosomes in regenerative medicine

Aysa Rezabakhsh  1 , Emel Sokullu  2 , Reza Rahbarghazi  3   4
Affiliations

Applications, challenges and prospects of mesenchymal stem cell exosomes in regenerative medicine

Aysa Rezabakhsh et al. Stem Cell Res Ther. .

Abstract

Recent advances in the identification and application of different stem cell types have offered alternative therapeutic approaches for clinicians. The lack of successful engraftment, migration into the injured site, loss of functionality and viability, ethical issues, shortage of donated allogeneic stem cells and the possibility of transmission of infectious are the main challenges associated with direct cell transplantation. The discovery and research on exosomes have led to the rise of hopes for the alleviation of different pathologies in regenerative medicine. Exo are nano-sized extracellular vesicles (40-150 nm) and released by each type. These nanoparticles participate in cell-to-cell communication in a paracrine manner. It is thought that the application of Exo can circumvent several drawbacks related to whole-cell therapies. Because of their appropriate size and stability, Exo are touted as therapeutic bullets transferring signaling factors into the acceptor cells in a paracrine manner. Despite these advantages, technologies associated with Exo isolation and purification are challenging because of heterogeneity in exosomal size and cargo. The lack of standard GMP-grade protocols is the main hurdle that limits the extensive application of Exo in the clinical setting. Here, the authors aimed to inspire a logical and realistic vision about problems associated with Exo application in regenerative medicine.

Keywords: Challenging; Disadvantages; Exosomes; Regenerative medicine; Whole-cell therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Several challenges are associated with the application of Exo in the clinical setting
Fig. 2
Fig. 2
The injection of Exo may lead to allo-/xeno-reactive T cell responses via the activity of APCs located inside the hepatic and splenic tissues. In addition, systemically injected Exo can be sequestrated in pulmonary and hepatic vascular beds. Another issue regarding Exo application is the promotion of thrombosis in the vascular niche. Harboring infectious agents via Exo can lead to transmission of these particles into the in vivo milieu
See this image and copyright information in PMC

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