MSC-Derived Exosomes: Advances in Cell-Free Therapy

Mesenchymal stem cells (MSCs)Mesenchymal stem cells (MSCs) are a rich source of bioactive molecules, which they secrete as a part of their paracrine activity. Additionally, given their immunomodulatory and differentiation capabilities, MSCs provide a promising therapeutic option in regenerative medicine. However, diverse challenges have hampered their progress to routine use in clinical settings, including cell viability post-engraftment, degree of in vitro expansion, long-term storage, and significant maintenance costs, besides a need for standardized and optimized protocols. MSCs-derived exosomes provide a potential therapeutic option emerging in translational research. They can address cell-based therapy’sMSCs-derived exosomescell-based therapy’s disadvantages and are, in some aspects, considered a superior alternative to cell-based therapy. Exosomes constitute the insoluble component of the paracrine secretions of stem/progenitor cells that help the communicating cells exchange required information regarding bioactive molecular delivery. Recent advancements in exosome research have enabled their payload modification by simply loading the exosomes with the molecules of interest or by manipulating or preconditioning the parent cells from which they are derived. More recent advances in their payload profiling and controlling their payload to include the molecules of interest for specific therapeutic use have further boosted researchers’ interest in exploiting them as carriers and therapeutic modalities. This chapter delves into the treatment applications of MSC-derived exosomes in multisystem disordersMSCs-derived exosomesmultisystem disorders and provides an overview of their cardiovascular applications.