Exosomes derived from Mesenchymal Stem Cells (MSC) have shown promise in the field of regenerative medicine including in treatment of Traumatic Brain Injury (TBI). MSC cultures further enhance generation of exosomes and their therapeutic effects.
Unlike stem-cell therapy, exosomes are likely to become an “off-the-shelf” therapeutic agent that can be delivered to patients in a timely manner. Furthermore, exosomes do not have the safety risks inherent in administering viable cells such as the risk of occlusion in microvasculature or unregulated growth of transplanted cells.
Unlike transplantation of exogenous neural stem/progenitor cells, MSC-derived exosomes that stimulate endogenous neural stem/progenitor cells to repair injured brain may have several main advantages including:
a) No ethical issue of embryonic and fetal cells
b) Less invasiveness
c) Low or no immunogenicity
d) Low or no tumorigenicity
Exosomes are promising as therapeutic agents because their complex cargo of proteins and genetic materials has diverse biochemical potential allowing participation in multiple biochemical and cellular processes. This is a crucial attribute in the treatment of complex diseases with multiple secondary injury mechanisms, such as TBI or SCI.
Further investigation is warranted to take full advantage of the regenerative potential of cell free MSC-derived exosomes, including the choice of MSC sources and their culture conditions, as these have been shown to impact the functional properties of the exosomes.