Stem Cell Applications in Exosome Treatment

What are the Functions of Exosomes?

They act as a kind of communication network in the body. They play a role in material transport and tissue recovery processes by providing signal communication between cells.

How Are They Formed?

At the first stage of formation, a part of the cell membrane is taken into the cell. The membrane, folding into itself again, forms a small vesicle. It then forms a structure called the “multivesicular body” (MVB), which contains many vesicles.

The multivesicular bodies fuse with the plasma membrane, and the contents of the multivesicular body are excreted outside the cell. All these processes are strictly controlled by signaling tools inside the cell. All these micro-vesicles are called “exosomes”.

What Are the Areas of Use?

• Acute Lung Injury
• Skin Rejuvenation
• Spot Treatment
• Graft vs Host Disease (GvHD)
• Hair Loss
• Spinal Cord Injury
• Duchenne Muscular Dystrophy
• Regulation of T and B Cells
• Wound Treatment
• Photo-Aging
• Atopic Dermatitis (AD)
• Osteoarthritis (OA)

Areas of Use of Mesenchymal Stem Cell-Derived Exosomes

Exosome Treatment for Skin Damage

Scar treatment, spot treatment, photo-aging and skin rejuvenation processes are the biological result of deformations that occur on the skin.

• It repairs the scar.
• It helps the skin maintain its lost elasticity and strength.
• It helps cells regain their lost properties due to aging, thanks to its regenerative abilities.
  

Exosome Application in Hair Loss

Hair loss, also known as alopecia or baldness, might occur for various reasons, such as aging, diseases, and medications. Exosomes provide a potential application area for the treatment of hair loss.

It accelerates the first stage of hair growth in which the hair grows continuously by enabling the hair follicles to be switched from the telogen phase to the anagen phase. By supporting the viability of exosomes, the growth factor is provided and facilitates the growth of the hair shaft in the hair follicles.

Exosome Treatment in Immunosystem Diseases

It supports the immune system by purifying the activation of regulatory T cells.

Exosome Treatment in Graft vs Host Disease (GvHD)

It is used prophylactically in the treatment of GvHD.

Exosome Treatment in Ovarian Rejuvenation

One of the signs of ovarian aging is a decrease in the number of follicles. Ovarian reserve is mainly defined by the quantity and quality of primordial follicles.

It is known that the amount of primordial follicles increases significantly and begins after mesenchymal stem cell-derived exosome intervention. Mesenchymal stem cell-derived exosome is used in the treatment of diseases such as polycystic ovary, ovarian development, uterine diseases, endometrial receptivity.

Exosome Application in Spinal Cord Injuries

Mesenchymal stem cell-derived exosomes have shown to have effective repair effects on SCI.

• It accelerates motor function and alleviates histopathologic damage by supporting neuronal regeneration.
• It suppresses apoptosis of neuronal cells and supports functional recovery.
• It promotes loco-motor functional recovery and reduces inflammation.
• It increases functional recovery and reduces complement activation caused by spinal cord injury.
• It may improve functional recovery and axonal regeneration.
• Thanks to the miRNA-21, miRNA-133b and miRNA-126 they contain, mesenchymal stem cell-derived exosomes repair deformations caused by spinal cord injury.
  

Exosome Treatment in Orthopedic Diseases

Cartilage Damage and Joint Calcification

Mesenchymal stem cell-derived exosomes enable the regeneration of cartilage tissue. It reduces inflammation and supports the proliferation of cartilage cells. It is used in the treatment of joint diseases such as osteoarthritis, talus.

Bone Healing

Mesenchymal stem cell-derived exosomes help fractures heal faster. It supports the re-formation of bone tissue by increasing the activity of osteoprogenitor cells.

Muscle and Tendon Injury

Mesenchymal stem cell-derived exosomes accelerate the recovery process of muscle and tendon injuries. They reduce inflammation in tendon injuries such as tendonitis and tendinosis and support rapid regeneration of tendon cells.

Ligament Injury

Mesenchymal stem cell-derived exosomes promote the regeneration of ligaments. This treatment provides rapid recovery from sports injuries and other traumatic situations.

Are There Any Side Effects?

The exosome treatment has no interaction with medicines and has no known side effects. It has not been tested for use during pregnancy and lactation.

Does the Application Have an Age Limit?

There is no specific age limit for exosome treatment; however, the effectiveness and appropriateness of the treatment may vary from person to person.

What are the Advantages of Treatment?

Exosomes affect cells by signaling to targeted cells and through the biomolecules they contain. As they are surrounded by a thin membrane, they easily transport to various tissues and organs in the body. It accelerates tissue repair and promotes recovery. As they are between 50 and 200 nm in diameter, they can easily pass through the blood-brain barrier.

How Common Is The Treatment?

Cellular therapies have been used worldwide for about 20 years. Interest in treatment has increased recently. It stands out as a current approach among cellular therapies thanks to its properties. It is a stem cell-derived but cell-free treatment method that has also started to be heard in our country in recent years. In this type of treatments, cellular products produced in licensed and certified centers should be preferred.

How is It Produced?

It is a demanding and sensitive method that requires special laboratory conditions. Umbilical cord-derived mesenchymal stem cells are reproduced in cGMP (current Good Manufacturing Practices) laboratories using appropriate culture methods. Cells that reach a sufficient number are exposed to stress by various methods and are enabled to produce exosomes.

The exosomes obtained are purified by appropriate purification method. Once the exosomes become the final product, they are stored as a homogeneous suspension in sterile form with a cold chain.

It is Prepared under Laboratory Conditions in Accordance with Quality Control Standards

In order for the application to be healthy, the quality standards of the exosomes produced are of great importance.
As LivMedCell Regenerative Medicine, Stem Cell Center, the following tests are applied in exosome product applications in accordance with quality control standards in our laboratory.

• Mycoplasma Analysis
• Endotoxin Test Analysis
• Microbial Detection/Gram Staining
• Flow Cytometry Analysis
• NTA (Nanoparticle Tracking Analysis) Test

The applications should be performed by specialized doctors and the exosomes produced should be prepared in laboratories with cGMP conditions approved by the Ministry of Health.

What are the Storage Conditions Like?

After production of exosomes, they can be stored at -152 oC. If desired, they are thawed by appropriate methods and transferred to the patient under conditions suitable for transplantation. The shelf life of the final product prepared for application to the patient is 1 week under appropriate storage conditions.