Clinical Applications of Exosomes: A Critical Review

Abstract

Exosomes, small membrane-bound vesicles secreted by cells, have gained significant attention for their therapeutic potential. Measuring 30-100 nm in diameter and derived from various cell types, exosomes play a crucial role in intercellular communication by transferring proteins, lipids, and RNA between cells. This review analyzes existing literature on the clinical applications of exosomes. We conducted a comprehensive search of peer-reviewed articles and clinical trial data to evaluate the benefits, limitations, and challenges of exosome-based therapies. Key areas of focus included regenerative medicine, cancer therapy, gene therapy, and diagnostic biomarkers. This review highlights the vast clinical applications of exosomes. In regenerative medicine, exosomes facilitate tissue repair and regeneration. In cancer therapy, exosomes can deliver therapeutic agents directly to tumor cells. In gene therapy, exosomes serve as vectors for gene delivery. As diagnostic biomarkers, they are useful in diagnosing various diseases. Challenges such as the isolation, purification, and characterization of exosomes were identified. Current clinical trials demonstrate the potential of exosome-based therapies, though they also reveal significant hurdles. Regulatory issues, including the need for standardization and validation of exosome products, are critical for advancing these therapies. While significant progress has been made in understanding exosome biology, further research is essential to fully unlock their clinical potential. Addressing challenges in isolation, purification, and regulatory standardization is crucial for their successful application in clinical practice. This review provides a concise overview of the clinical applications of exosomes, emphasizing both their therapeutic promise and the obstacles that need to be overcome.

Keywords: cancer therapy; diagnostic biomarkers; exosomes; regenerative medicine; therapeutic potential.

Figure 1

This Figure illustrates the relative sizes of various biological entities. Exosomes, ranging from 30 to 100 nm, are comparable in size to viruses. Larger extracellular vesicles, known as microvesicles, fall within the 100 nm to 1 µm range. Apoptotic bodies, which are even larger, measure between 1 µm and 5 µm. For comparison, platelets are in the 1 µm to 5 µm range, while cells are significantly larger, measuring 8–12 µm. This Figure highlights the size scale from exosomes to cells, demonstrating the hierarchical structure of these biological components.

Figure 2

Exosomes between the cells (purple-colored) function as intercellular communicators, facilitating the transfer of proteins (green), lipids (red), and RNA (blue).

Figure 3

The diverse medical applications of exosomes. The arrows represent the various sources and applications of exosomes in different medical fields. The versatile roles of exosomes in advancing medical science offer novel approaches for diagnosis, treatment, and monitoring of various health conditions.

Figure 4

There has been a recent surge in interest in exosomes derived from the human pharynx (EXOP by Sihler Inc., Seoul, Republic of Korea, and Exodew by Hyundai Meditech Inc., Wonju, Republic of Korea). Stem cells collected via swab-based sampling during pharyngeal examinations, such as those conducted for early childhood influenza, are recognized for their outstanding differentiation abilities.

Figure 5

Pharyngeal stem cells obtained through swab-based sampling during examinations, such as influenza screenings in early childhood, are recognized for their remarkable differentiation capabilities.

Figure 6

Recent technology using screening to keep the health data of donors and inspections of exosomes.