The Role of Exosomes in Regenerative Medicine

In recent years, a new dimension has been added to stem cell therapy with the discovery of mesenchymal stem cell exosomes. The main effect created by exosomes  is to repair damaged tissue and down regulate inflammation .

Exosomes are tiny extracellular vesicles (EV’s), which are secreted by human mesenchymal stem cells (hMSC) to injured or degenerative cells for the purpose of initiating a profound healing response. These vesicles are filled with nano particles containing powerful regenerative capacities.

Mesenchymal EV’s contain messenger RNA (mRNA), microRNAs (miRNAs), regenerative enzymes, cytokines, and growth factors that modulate function and homing of immune cells to regulate survival and proliferation of healthy tissue.

In microbiology injured or diseased cells will send distress signals  to nearby resident stem cells. Upon receiving the stress signal the responding MSC’s will release exosomes that will migrate to receptor sites on the diseased cells. The regenerative cargo from the exosomes will make their way into the cytoplasm of the target cell and begin a regenerative response to correct the disregulation of that cell.

Exosomes participate in intercellular communication events and contribute to the healing of injured or diseased tissues and organs. Studies show that exosomes alone may be greatly responsible for the therapeutic effects of MSCs in numerous experimental models. Therefore, MSC-derived exosomes may be applied to establish a novel cell-free therapeutic approach for treatment of a variety of diseases including musculoskeletal conditions (injuries and arthritic conditions) as well as degenerative heart, kidney, liver, immune and neurological diseases, and cutaneous wound healing. In comparison with their donor cells, MSC-derived exosomes offer a more stable method and improved  safety profile with regards to the IV administration of live cells,  minimizing the risk of  microvasculature occlusion and or clotting occurrence.

In an orthopedic clinical context, exosomes have shown promise in treating various conditions from joint and ligament injury to inflammatory connective tissue disorders. Their ability to deliver growth factors and other regenerative substances directly to damaged tissues could revolutionize current orthopedic regenerative treatment approaches.

In many cases we will combine IV exosomes for a general whole body regenerative affect and inject MSC/growth factors to the injured orthopedic joint, ligament or tendon for an increased healing response.

Some of the conditions treated with IV exosomes  cited in the literature:

Musculoskeletal – Joints, discs, muscles, bones, ligaments, tendons
Neurodegenerative – MS, Parkinson’s, Alzheimer’s, Huntington’s, ALS, Cerebellar Ataxia CNS Injury/Trauma – CVA, CTE, TBI, SCI, Transverse Myelitis, Cerebellar Ataxia Burns/Scars/Ulcers

Heart Disease – MI, Angina, CHF
Lung Disease – COPD, Pulmonary Fibrosis, Interstitial Lung Disease Liver Disease
Kidney Disease
Inflammatory Bowel Disease – UC, Crohn’s
Erectile Dysfunction
Urinary Incontinence
Peripheral Vascular Disease
Cerebral Palsy/Seizure Disorders/Autism
Numerous Aesthetic Applications
Depression/Bipolar Disorder
Drug Addiction
Type II Diabetes Mellitus


To learn more, check out:

The Role of Exosomes in Regenerative Medicine by Douglas Spiel, MD