Exosomes – Frequently Asked Questions
What are the contents inside the exosomes?
What conditions may be aided by exosomes?
What are some of the benefits of exosomes?
How many treatments are usually needed?
How long will it take to see results?
How are exosomes administered?
Can exosomes be combined with other therapies?
Contraindications: Are there reasons NOT to get exosome therapy?
Selected Research Articles on Exosomes
What are exosomes?
Once thought to be the garbage bins for excess proteins and undesirable molecules of cells, exosomes are becoming recognized as an integral component of cell to cell communication and a novel therapeutic tool for the treatment of various diseases.
Exosomes are extraordinarily tiny particles found in all mammalian cells that act as a vehicle to transmit cellular messages between cells. They are able to carry messages between both nearby and distant cells of the same cell type and different cell types. For example, it has been shown that exosomes are involved with the cell to cell communication between neurons and glial cells – an immune cell associated with the nervous system.
Cellular communication plays important roles in many aspects of human health including development, immunity, cellular health and homeostasis, neurodegenerative disease, cardiovascular disease, orthopedic conditions and more.
The messages exosomes carry can promote cellular repair and regeneration, reduce inflammation and oxidative stress, modulate the immune system by regulating T cells, B cells and natural killer cells, and improve overall cellular health. Exosomes also stimulate the production of cellular energy by protecting and improving the function of mitochondria – the power plant of all cells.
Due to their small size of 40-100 nanometers which is roughly one millionth the size of a human hair, exosomes can travel long distances in the body. They can even cross the blood brain barrier which is essential for the treatment of neurodegenerative diseases, traumatic brain injury and other conditions affecting the brain.
Exosomes are able to target and travel to areas of injury and inflammation not only because of their size but because of special protein receptors on their surface. They also evade the immune system so they are able stay in circulation for an extended period of time and have a prolonged therapeutic effect.
What are the contents inside the exosomes?
The content of exosomes is diverse and includes proteins, lipids, growth factors, genetic material such as mRNA, microRNA and other material which act as messaging molecules to affect the behavior of other cells. Important immune system associated proteins include IL-6 which is responsible for activating macrophages – an important and common cell of the immune system, IL-10 which is responsible for modulating the immune system and reducing inflammation, TNFR1 which reduces inflammation by inactivating TNF-alpha – a major inflammatory molecule, and many others.
Exosomes also contains various growth factors. These include GDF15 which regulates inflammation, cell repair and growth, GDNF and BDNF which promotes survival of neurons, HGF which is involved with organ regeneration and wound healing, TGFB3 which is one of the most important anti-inflammatory growth factors due to its function of converting inflammatory immune cells (Th1 T cells) to anti-inflammatory immune cells (regulatory T cells)and many others. Exosomes also contain genetic material such as messenger RNA and microRNA which influences DNA and the creation of new proteins, etc. Some mRNA found in exosomes include GDF11 which is a potent anti-aging agent, BMP4 which is involved in bone and cartilage repair, PTEN which is a potent tumor suppressor gene and many others.
What can exosomes do?
As a vehicle for communication between nearby and distant cells, Exosomes have the ability to promote longevity by transmitting regenerative signals that stimulate the repair of old, damaged, and or dysfunctional cells and modify cell behavior throughout the body. Cells that are old, damaged, and or dysfunctional are not only involved with the aging process, but are also associated with the development of many diseases. Repairing such cells reestablishes cellular function and ultimately leads to improved cellular health. In addition to repair and regenerative properties, exosomes reduce inflammation, oxidative stress and fibrosis; modulate the immune system by regulating T cells, B cells and natural killer cells, support mitochondrial function, increase cellular energy production, and more. All of which are vital in the treatment of disease processes that involve inflammation, ischemia, fibrosis, immune dysregulation, oxidative stress, etc. Exosomes are being used in many aspects of health such as aesthetic and cosmetics, anti-aging and longevity medicine. They are also being used in the treatment of various conditions including, orthopedic conditions, neurodegenerative disease, cardiovascular disease, kidney disease, autoimmune disease, and more.
What conditions may be aided by exosomes?
- Musculoskeletal – joints, discs, muscles, bone, ligaments, tendons and cartilage
- Neurodegenerative – Multiple sclerosis, Alzheimer’s disease, ALS, etc.
- Skin – burns, scars, ulcers
- Cardiovascular disease
- Liver disease
- Kidney disease
- Inflammatory bowel disease
- Alopecia
- Urology – Erectile dysfunction, urinary incontinence
- Cerebral palsy and Autism
- Type II diabetes
- Infertility
- Aging
Read more on The Role of Exosomes in Regenerative Medicine.
What are some of the benefits of Exosomes?
- They can travel throughout the body without the risk of clumping or getting stuck in non-target organs.
- They can stay in circulation longer because they do not become trapped in the lung after IV administration .
- They can cross the blood brain barrier which is important for brain injury and neurodegenerative conditions.
- They are able to evade the immune system and stay in circulation longer.
- They do not contain DNA so there is no risk of cancer/tumor formation.
- They do not require harvesting procedure from patient.
- Can be used in combination with many other regenerative therapies.
Read more on The Role of Exosomes in Regenerative Medicine.
Where do exosomes come from?
Exosomes are found in all mammalian cells and are involved with cell to cell communication. Exosomes are isolated from human placenta derived stem cells and amniotic fluid in a FDA registered, GMP compliant laboratory. The exosome product is 100% natural and free of animal tissue.
Is exosome therapy safe?
Exosome products used by clinics are produced in a FDA registered, GMP compliant laboratory and are rigorously screened, beyond the FDA requirements for contaminates and viruses.
The safety of exosomes used in the treatment of various conditions has been documented.
Exosomes do not contain DNA and therefore there is no risk of malignant transformation. They also lack specific surface markers which eliminates the risk of immune rejection.
How many treatments are usually needed?
This is a difficult question to answer accurately because the number of treatments needed to improve a patient’s health depends on a number of different factors. These factors include the condition being treated, the severity of the condition, the patient’s age, the patient’s overall health status and other factors affecting their response to therapy. For instance, a patient may receive exosome therapy every day for cosmetic conditions, every couple weeks for neurodegenerative conditions or every few months for longevity purposes. The doctor will discuss the most beneficial number and frequency of treatments based on the patient’s condition and other factors impacting their health during the consultation.
How long will it take to see results?
Each patient is unique with their own factors affecting their response to therapy. There is no guarantee of what the results will be or the time it will take to see results. Some patients have reported immediate results while others have reported results within 1-6 months after treatment. There are some patients who have received treatment with only minimal improvement or no improvement at all. After reviewing their case, the doctor will discuss a general time frame to expect results although there is no definite guarantee.
How are exosomes administered?
Exosomes can be administered in a number of ways depending on the condition being treated. For example, exosome creams can be applied topically as a regenerative skin treatment, can be given in a nasal spray for neurocognitive conditions, injected into joints and soft tissue for orthopedic conditions and given IV for whole body effects for neurodegenerative conditions, autoimmune conditions, for anti-aging and longevity purposes and more. This will all be discussed during the consultation.
Can exosomes be combined with other therapies?
Yes. Exosome therapy can be used in combination with various regenerative treatments including stem cell therapy, nutritional IV therapy, platelet rich plasma (PRP) injections, bio-identical hormone therapy, peptide therapy and others to maximize effects and impact on health. Combining stem cell therapy with exosome therapy is considered to be a superior and optimal combination for healing and repair because the exosomes help activate the administered stem cells and stem cells already in the body.
Contraindications: Are there reasons not to get exosome therapy?
Exosome therapy has been documented to be safe however there are some conditions that exosomes should not be used in.
- Cancer
- Myeloproliferative disease
- Bone marrow dysplasia
- Sickle cell anemia
- Primary pulmonary hypertension
- Acute bacterial infection
- Recent dental work
- Macular degeneration
- Any condition with abnormal neovascularization
- Immune-compromised patients
Read more on The Role of Exosomes in Regenerative Medicine.
Selected Research Articles on Exosomes
- Umbilical cord mesenchymal stem cells derived extracellular vesicles can safely ameliorate the progression of chronic kidney diseases.
Nassar, W., El-Ansary, M., Sabry, D., Mostafa, M. A., Fayad, T., Kotb, E. Adel, H. (2016). Biomaterials Research, 20(1). https://doi.org/10.1186/s40824-016-0068-0 - Exosome Therapy for Stroke.
Chen, J., & Chopp, M. (2018). Stroke, 49(5), 1083–1090. https://doi.org/10.1161/STROKEAHA.117.018292 - Mesenchymal stem cell-derived exosomes: A novel potential therapeutic avenue for cardiac regeneration.
Safari, S., Malekvandfard, F., Babashah, S., Alizadehasl, A., Sadeghizadeh, M., & Motavaf, M. (2016). Cellular and Molecular Biology (Noisy-Le-Grand, France), 62(7), 66–73. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/27453275 - Emerging Role of Stem Cells – Derived Exosomes as Valuable Tools for Cardiovascular Therapy.
Rosca, A.-M., Rayia, D. M. A., & Tutuianu, R. (2017). Current Stem Cell Research & Therapy, 12(2), 134–138. https://doi.org/10.2174/1574888X10666151026115320 - The potential of exosomes in the therapy of the cartilage and bone complications; emphasis on osteoarthritis.
Pourakbari, R., Khodadadi, M., Aghebati-Maleki, A., Aghebati-Maleki, L., & Yousefi, M. (2019). Life Sciences, 116861. https://doi.org/10.1016/j.lfs.2019.116861 - Stem cell-derived extracellular vesicles for treating joint injury and osteoarthritis.
Li, J. J., Hosseini-Beheshti, E., Grau, G. E., Zreiqat, H., & Little, C. B. (2019, February 1). Nanomaterials, Vol. 9. https://doi.org/10.3390/nano9020261 - Exosomes in ischemic heart disease: novel carriers for bioinformation.
Zhou, H., Wang, B., Yang, Y., Jia, Q., Qi, Z., Zhang, A., … Zhang, J. (2019). Biomedicine & Pharmacotherapy, 120, 109451. https://doi.org/10.1016/j.biopha.2019.109451 - Exosomes Isolated From Human Umbilical Cord Mesenchymal Stem Cells Alleviate Neuroinflammation and Reduce Amyloid-Beta Deposition by Modulating Microglial Activation in Alzheimer’s Disease.
Ding, M., Shen, Y., Wang, P., Xie, Z., Xu, S., Zhu, Z., … Yang, H. (2018). Neurochemical Research, 43(11), 2165–2177. https://doi.org/10.1007/s11064-018-2641-5 - Tiny Shuttles for Information Transfer: Exosomes in Cardiac Health and Disease.
Kishore, R., Garikipati, V. N. S., & Gumpert, A. (2016). Journal of Cardiovascular Translational Research, 9(3), 169–175. https://doi.org/10.1007/s12265-016-9682-4 - Umbilical cord mesenchymal stem cells derived extracellular vesicles can safely ameliorate the progression of chronic kidney diseases. Nassar, W., El-Ansary, M., Sabry, D., Mostafa, M. A., Fayad, T., Kotb, E. Adel, H. (2016). Biomaterials Research, 20(1). https://doi.org/10.1186/s40824-016-0068-0
- Exosome Therapy for Stroke.Chen, J., & Chopp, M. (2018). Stroke, 49(5), 1083–1090. https://doi.org/10.1161/STROKEAHA.117.018292
- Mesenchymal stem cell-derived exosomes: A novel potential therapeutic avenue for cardiac regeneration.Safari, S., Malekvandfard, F., Babashah, S., Alizadehasl, A., Sadeghizadeh, M., & Motavaf, M. (2016). Cellular and Molecular Biology (Noisy-Le-Grand, France), 62(7), 66–73. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/27453275
- Emerging Role of Stem Cells – Derived Exosomes as Valuable Tools for Cardiovascular Therapy.Rosca, A.-M., Rayia, D. M. A., & Tutuianu, R. (2017). Current Stem Cell Research & Therapy, 12(2), 134–138. https://doi.org/10.2174/1574888X10666151026115320
- The potential of exosomes in the therapy of the cartilage and bone complications; emphasis on osteoarthritis.Pourakbari, R., Khodadadi, M., Aghebati-Maleki, A., Aghebati-Maleki, L., & Yousefi, M. (2019). Life Sciences, 116861. https://doi.org/10.1016/j.lfs.2019.116861
- Stem cell-derived extracellular vesicles for treating joint injury and osteoarthritis. Li, J. J., Hosseini-Beheshti, E., Grau, G. E., Zreiqat, H., & Little, C. B. (2019, February 1). Nanomaterials, Vol. 9. https://doi.org/10.3390/nano9020261
- Exosomes in ischemic heart disease: novel carriers for bioinformation. Zhou, H., Wang, B., Yang, Y., Jia, Q., Qi, Z., Zhang, A., … Zhang, J. (2019). Biomedicine & Pharmacotherapy, 120, 109451. https://doi.org/10.1016/j.biopha.2019.109451
- Exosomes Isolated From Human Umbilical Cord Mesenchymal Stem Cells Alleviate Neuroinflammation and Reduce Amyloid-Beta Deposition by Modulating Microglial Activation in Alzheimer’s Disease.Ding, M., Shen, Y., Wang, P., Xie, Z., Xu, S., Zhu, Z., … Yang, H. (2018). Neurochemical Research, 43(11), 2165–2177. https://doi.org/10.1007/s11064-018-2641-5
- Tiny Shuttles for Information Transfer: Exosomes in Cardiac Health and Disease. Kishore, R., Garikipati, V. N. S., & Gumpert, A. (2016). Journal of Cardiovascular Translational Research, 9(3), 169–175. https://doi.org/10.1007/s12265-016-9682-4
