Clinical applications of stem cell-derived exosomes

Abstract

Although stem cell-based therapy has demonstrated considerable potential to manage certain diseases more successfully than conventional surgery, it nevertheless comes with inescapable drawbacks that might limit its clinical translation. Compared to stem cells, stem cell-derived exosomes possess numerous advantages, such as non-immunogenicity, non-infusion toxicity, easy access, effortless preservation, and freedom from tumorigenic potential and ethical issues. Exosomes can inherit similar therapeutic effects from their parental cells such as embryonic stem cells and adult stem cells through vertical delivery of their pluripotency or multipotency. After a thorough search and meticulous dissection of relevant literature from the last five years, we present this comprehensive, up-to-date, specialty-specific and disease-oriented review to highlight the surgical application and potential of stem cell-derived exosomes. Exosomes derived from stem cells (e.g., embryonic, induced pluripotent, hematopoietic, mesenchymal, neural, and endothelial stem cells) are capable of treating numerous diseases encountered in orthopedic surgery, neurosurgery, plastic surgery, general surgery, cardiothoracic surgery, urology, head and neck surgery, ophthalmology, and obstetrics and gynecology. The diverse therapeutic effects of stem cells-derived exosomes are a hierarchical translation through tissue-specific responses, and cell-specific molecular signaling pathways. In this review, we highlight stem cell-derived exosomes as a viable and potent alternative to stem cell-based therapy in managing various surgical conditions. We recommend that future research combines wisdoms from surgeons, nanomedicine practitioners, and stem cell researchers in this relevant and intriguing research area.

Native and engineered extracellular vesicles: novel tools for treating liver disease

“…precipitation- and microfluidics-based) might be a solution to simultaneously meet multiple requirements for exosome isolation and purification. 128 Regardless of the method used, the complete isolation and purification of EVs is not practical; therefore, EVs must be characterized via various techniques in study phase to evaluate the isolation effect and exclude the effect of other confounding substances. Researchers must combine analyses from three different aspects (size, morphology, and cargo profile) to identify isolated EVs, which are usually packaged for transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and western blotting.…”

Advances in the application of extracellular vesicles derived from three-dimensional culture of stem cells

“…Clinical applications require large quantities of EVs, and although the 3D culture method can increase the production of EVs, there is still a long way to go before the large-scale manufacturing of EVs. Moreover, EVs should be subjected to strict quality control before clinical applications, but there is a lack of documents on industry-standard quality specifications for EVs [ 187 ]. In addition, the safety evaluation of EVs for long-term in vivo application still needs to be tracked and recorded to determine whether EVs are safe and reliable in vivo.…”

Stem Cell-Derived Exosomes: An Advanced Horizon to Cancer Regenerative Medicine

“…Developing methods for long-term storage without compromising their therapeutic properties is still a challenge . Stem cell-based exosomes production, stability, toxicity, dose of treatment, and size diversity of each production batch are complicated challenges in this domain of clinical application. ,,,− Lower zeta values of exosomes promote aggregation of exosomes. This is a key point in stem cell exosomes off-target toxicity. ,, Natural production of trehalose reduces the exosomes aggregation problem .…”