Composition and Possibility of Application in Practical Medicine of Exosom/Extracellular Vesicles from Multipotent Stromal Cells

The therapeutic effect of multipotent stem cells (MSCs) is largely mediated by the secretion of exosomes/extracellular vesicles (EMSCs), which reflect the biophysical characteristics of MSC-producers and are considered more effective. The use of EMSCs can help overcome practical and ethical issues that limit cell therapy. The importance of EMSCs is also recognized because of their ability to transfer various proteins, DNA and RNA to target cells and change the behavior of them and neighboring cells. EMSCs contribute to cellular processes such as transcription, proliferation, adhesion, migration and differentiation. EMSCs are involved in the induction of angiogenesis, inhibition of fibrosis, stimulation of extracellular matrix remodeling, abolition of the local inflammatory response, and also in the regulation of immune cell activity. A deeper understanding of the content of EMSC and its dynamics may affect the study and treatment of various diseases. However, EMSCs, even obtained from MSCs of the same origin and cultivated under the same conditions, can differ significantly in their components and, accordingly, in efficiency. Modification, including genetic modification, of the initial cellular elements is of certain importance for purposeful and, therefore, predictable changes in the content of EMSCs, but this approach also does not solve the problem of sufficient standardization of their components. Perhaps more promising is the artificial creation of exosome-like structures with a predetermined composition and, as a result, an accurate and predictable effect.