Exosomes Q & A

Q & A for Mesenchymal Stem Cells and Exosomes

Q: What are mesenchymal stem cells (MSCs)?

A: Adult (non-embryonic) mesenchymal stem cells are undifferentiated cells that have the ability to replace dying cells and regenerate damaged tissue. These special cells seek out areas of injury, disease, and destruction. Once there, they are capable of regenerating healthy cells and accelerating the natural healing process. 

There is increasing amounts of evidence that supports the use of stem cells to treat autoimmune diseases, restore joint function, and many other potential uses. 

We use treatments that include Adult MSCs rather than embryonic stem cells and induced pluripotent stem cells for both scientific and moral reasons. 

Both embryonic and induced pluripotent stem cells are known to form tumors. There is currently no known occurrence of MSCs forming tumors.

RHM uses MSC-derived Exosomes for many of our regenerative treatments and therapies

Q: What are exosomes?

A: Exosomes are membrane-enclosed nanovesicles that are facilitators of cell-to-cell communication. They facilitate the exchange of biological information between different cell types. They travel to the target area, which are then taken up by the target’s cells to facilitate healing.

Exosomes are 100 nm lipid vesicles that are secreted by MSCs. 

Q: Why exosomes rather than MSCs?

A: Exosomes posses a strong regenerative potential and can normalize various pathological and inflammatory processes in chronic issues. 

Q: What are the conditions that can benefit from an exosome treatment?

A: Beneficial uses of mesenchymal stem cell exosomes include but are not limited to:
• Chronic inflammatory and autoimmune diseases 

• Chronic fatigue syndrome 

• Neurodegenerative diseases including Parkinson disease, multiple sclerosis, stroke, chronic demyelinating inflammatory neuropathies, etc (exosomes penetrate through the blood brain barrier) 

• Arthritis 

• Acute and chronic tendinitis and tendinosis 

• Muscle fatigue and muscle weakness 

• Coronary artery disease and congestive heart failure 

• Chronic hepatitis and other liver diseases 

• Chronic kidney diseases

Q: What is the source of stem cell-derived exosomes? 

A: Exosomes used in an RHM office are obtained from human placental stem cells. Prior to use, the donated placentas are extensively tested for a number of viruses. Exosomes are produced in a FDA registered tissue facility that follows cGMP production procedures and holds both ISO 9001 and ISO 13485 quality control certification. The production of exosomes is regulated as a 351 tissue product by the Food and Drug Administration.

Q: How are exosomes administered? 

A: For systemic illnesses and as a part of anti-aging therapy, exosomes are administered intravenously. As a part of joint regenerative therapy, exosomes are administered via intraarticular (joint) injections. For some therapies, exosomes are administered intranasally.

Q: How soon after administration of exosomes can a person can expect to see the benefits? 

A: Every individual is different, but two key determinants for success are the severity of your condition and your body’s response to exosome therapy. Typically, early benefits of therapy are observed in 3-4 months. However, it is not uncommon, to not see the benefits until after 9 to 12 months.

Q: What Can I Expect After the Procedure? Are there any side effects? 

A: Exosome transplantation is usually done on an outpatient basis; most patients should expect to walk out of the office without any major pain or problems. Generally speaking, aside from the initial pain at the point of injection from the needle, the patient will not experience any discomfort. Less than 10% of (mostly lumbar puncture) patients have developed a minor fever, headache, nausea, or vomiting. However, these side effects have never lasted more than three days and usually resolve within 24 hours. No long term negative side effects have been reported.

Q: When Can I Resume Physical Activity? 

A: For the procedure to have the best chance of lasting benefit, we strongly recommend: 

• Refraining from anti-inflammatory medication 

• Resting for the first 24–48 hours, but do not lie sedentary 

If procedure is joint related: 

• Cardio is allowed after 3–4 days 

• After two weeks, weight lifting and running are permitted

Q: Are exosomes safer than stem cells? 

A: Stem cells can proliferate and establish in the recipient’s body possessing a certain risk of undesirable complications such as new tumor growth. While there is currently no known occurrences of Adult MSCs forming tumors, exosomes do not proliferate but rather transfer valuable biological signals to the recipient’s tissues and facilitate the normalization of various pathological processes.

Q: How do exosomes benefit the inflammatory processes? 

A: Adult stem cell-derived exosomes induce high levels of anti-inflammatory cytokines, in contrast to decreased levels of pro-inflammatory molecules. In addition, they can also inhibit abnormal macrophage activation. The macrophage is a large white blood cell that is an integral part of our immune system. Its job is to locate microscopic foreign bodies and ‘eat’ them. However, disproportional macrophage activation can induce undesirable inflammatory processes.

Q: How does exosome therapy benefit patients with chronic infections and autoimmune diseases? 

A: Chronic infections have a lot in common with autoimmune diseases, including dysregulated immune response incapable of protecting our body from intruders (bacteria, viruses, molds, etc.) while attacking its own tissues and organs thus causing significant structural damage. One of the key mechanisms controlling the direction of immune responses is a balance between specific immune cells involved in protection vs autoimmune responses, the Th17/Treg ratio. This ratio is significantly abnormal in patients with both chronic infections and autoimmune diseases. Exosomes from mesenchymal stem cells normalize this ratio and bring the deviant immune response back to normal.

Q: How can exosomes benefit musculoskeletal disorders? 

A: Experimental data show that Adult stem cell-derived exosomes stimulate bone growth and skeletal muscle regeneration by directing the stem cells specifically into muscle and bone cell precursors.

Q: How can exosomes benefit neurodegenerative diseases? 

A: Exosomes are able to penetrate the blood-brain barrier and stimulate neuronal differentiation, neuronal growth, and suppress inflammatory processes within the brain tissue.