Exosomes: The New Kid on the Block in Orthobiologics

New, biomechanically sound tendon tissue after injection of uncultured, autologous, adipose derived regenerative cells in partial Achilles tendon defects in rabbits

“…On the other hand, the perfect animal model for tendinopathy does not exist, and models should be carefully considered in light of the specific research question [98]. In line with this the animal model used in the present study would be inadequate for investigating the efficacy of orthobiologics that aim at stimulating tissue-resident cells such as platelet rich plasma (PRP) [99][100][101] or exosomes derived from cultured stem cells [102][103][104]. In this regard, a recent double-blinded, randomized controlled clinical trial concluded that injections of PRP might not be beneficial in non-operative treatment of rotator cuff disease [105,106].…”

Nothing Heals Without Cells

“…In a series of editorials, I have attempted to provide rigorous information in this rapidly evolving area: first describing both the tremendous potential and also perils of regenerative medicine, followed by defining what is a stem cell, and finally by focusing on exosomes produced by stem cells. [7][8][9] Herein I will continue to develop this theme on cell therapy, focusing on the need to understand the complex interactions between the cells we inject and the endogenous cells already present in the treated joint or tissue.…”

“…The contemporary understanding of the primary action of exogenous cells (cell therapy) is that they act via a paracrine effect by the various cytokines and other signaling molecules contained in exosomes. 8 The signaling factors produced by exogenous cells can be both symptom modifying and potentially structure modifying (tissue healing and regeneration). Such signaling molecules will act on cells in the local microenvironment and also may possibly affect more distant cells.…”