Because of their high biological activity, umbilical cord-derived exosomes are widely considered to be the most effective source for therapeutic use. The abundant growth factors and proteins found in umbilical cord exosomes make them particularly effective for deep skin rejuvenation and wound repair. At the beginning of the 21st century, cell therapy, defined as a series of strategies based on the use of living cells for therapeutic purposes, emerged as a promising tool in the field of biomedicine. The goal of cell therapy is to repair, replace, or restore the biological functions of a damaged organ or tissue.
Research efforts in regenerative medicine have focused primarily on the use of mesenchymal stem cells (MSCs).
The main clinical application of exosomes is to use them as biomarkers, as cell-free therapeutic agents, as carriers for drug delivery, as basic analyses of exosome kinetics and as vaccines against cancer.
In several clinical trials, different exosomes of human or plant origin are used. Most researchers used exosomes from the circulatory system for experiments with Biomarkers. Mesenchymal stem cells (MSCs) and dendritic cells (DCs) are two widely used cell sources for the use of exosomes.MSC-derived exosomes are commonly used for the treatment of inflammation and drug delivery, while DCS exosomes are used to induce an inflammatory response in cancer patients. However, the clinical application of exosomes poses several questions and challenges. In addition, exosome-based clinical trials need to be translated to conform to specific Good Manufacturing Practices (GMP). In this review, we summarize exosomes in clinical trials according to the type of application and the disease.
We also address major questions and challenges related to exosome kinetics and clinical applications. First, there is a need to focus on the large scale pretherapeutic production of exosomes, a high-performance cellular source, and a reproducible and scalable production and isolation protocol. However, issues such as the inadequacy of clinical indications for the treatment of exosomes and the scarcity of parental stem cell sources remain unaddressed. These adult stem cells have different properties depending on the tissue source from which they are obtained and play a crucial role in the regeneration and repair of various tissues.
The function of the exosome is totally dependent on the source of the donor cells and can be constructive or destructive. Finally, of the 40 clinical trials in which stem cell-derived exosomes were used to treat diseases, 38 (95%) used MSC and 2 (5%) used iPSC as a cellular source of exosomes. Most exosome production and isolation techniques focus on the use of mammal sources. (cells, tissues and body fluids).
However, exosomes that are isolated from specific sources, such as MSC-derived exosomes, have been identified as a promising option for cell therapies. Finally, exosomal charges are released into the cytoplasm, whose process depends on the source of the exosome, the nature of the charge, and the metabolic state of the recipient cell. This review will focus on the functional functions, sources and biogenesis of exosomes in the body, isolation techniques, and recent advances in therapeutic studies. So far, many clinical trials are being carried out with exosomes from different sources for various diseases.
Undoubtedly, these “conventional” sources provide an important basis for understanding the functions of EXs in a number of physiological processes, as well as for their possible subsequent use in biomedicine (Jing et al. The purpose of this review is to briefly summarize conventional and unconventional sources of exotic substances, typical storage conditions and isolation methods, general-purpose kits and new “intelligent” technologies, emphasizing the influence of isolation techniques on the content of exotic substances, the detection of proteins, RNA, mRNA, etc. InSCs were obtained by reprogramming somatic cells, which opened a new window for obtaining therapeutic exosomes. However, in recent decades, a growing number of studies have revealed that many other sources have remarkable characteristics and they clarify some biological processes.
