Regenerative potential and clinical application of mesenchymal stem cell-derived exosomes (review)

For more than 50 years, mesenchymal stem cells have been extensively studied as a therapeutic agent in the treatment of various diseases. It became clear that MSC-derived secretome including the growth factors, cytokines, microvesicles and exosomes are the major drivers in the realization of beneficial effect of MSC-based therapy. Exosomes play an important role in the organism homeostasis and diseases development working as a vehicle for the transfer of the signaling and regulatory molecules between cells. Exosomes size, stability, cargo content that reflect the physiological state of parent cells make them an attractive new tool for regenerative medicine. Cell-free therapy or cell therapy 2.0 are being developed. Here, we review the molecular profile of exosomes derived from different MSC sources and their biological properties, the results of clinical application of MSC-derived exosomes in the of treatment COVID-19, alopecia, skin aging and osteoarthritis, discuss what issues exist in the development and application of a new biomedical product. The purpose of this study was to analyze the literature data on the regenerative potential and clinical application of exosomes derived from mesenchymal stem cells. Materials and methods. An analytical review of literature data was conducted using the information analysis of Medline (PubMed), Web of Science and Scopus databases, Google Scholar and the Cochrane Central Register of Controlled Trials (CENTRAL) and other sources until 2022 inclusive using the keywords: «exosomes», «mesenchymal stem cells», «cell-free therapy», «secretome», «miRNA» Results. In this review, we consider the molecular profile of exosomes derived from different MSC sources and their biological properties, the results of clinical application of MSC-derived exosomes in the treatment of COVID-19, alopecia, skin aging and osteoarthritis, discuss what issues exist in the development and application of a new biomedical product. Conclusion. The study, research and development of biotechnological products based on exosomes from different stem cell types are new stages in the development of regenerative medicine. Understanding the unique biological properties of MSCs derived from various tissue sources is one of the keys to develop effective exosomes-based biotechnological products to address specific medical goals.