Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Aug 26, 2020; 12(8): 814-840
Published online Aug 26, 2020. doi: 10.4252/wjsc.v12.i8.814
Mesenchymal stem cell-derived exosomes: Toward cell-free therapeutic strategies in regenerative medicine
Zhan-Jun Ma, Jing-Jing Yang, Yu-Bao Lu, Zhao-Yang Liu, Xue-Xi Wang
Zhan-Jun Ma, Jing-Jing Yang, Yu-Bao Lu, The Second Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu Province, China
Zhao-Yang Liu, Department of Medical Imaging, Shanxi Medical University, Jinzhong 030600, Shaanxi Province, China
Xue-Xi Wang, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Ma ZJ wrote the manuscript; Yang JJ, Lu YB, and Liu ZY collected the literature; Wang XX revised the manuscript for important intellectual content.
Supported by the Chinese Medicine Administration Research Project of Gansu Province, No. GZK-2019-46; and the Cuiying Technology Innovation Project of Lanzhou University Second Hospital, No. CY2019-MS10.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Xue-Xi Wang, MD, Professor, School of Basic Medical Sciences, Lanzhou University, 205 South Tianshui Road, Lanzhou 730000, Gansu Province, China.
Received: March 15, 2020
Peer-review started: March 15, 2020
First decision: April 7, 2020
Revised: April 23, 2020
Accepted: June 27, 2020
Article in press: June 27, 2020
Published online: August 26, 2020

Mesenchymal stem cells (MSCs) are multipotent stem cells with marked potential for regenerative medicine because of their strong immunosuppressive and regenerative abilities. The therapeutic effects of MSCs are based in part on their secretion of biologically active factors in extracellular vesicles known as exosomes. Exosomes have a diameter of 30-100 nm and mediate intercellular communication and material exchange. MSC-derived exosomes (MSC-Exos) have potential for cell-free therapy for diseases of, for instance, the kidney, liver, heart, nervous system, and musculoskeletal system. Hence, MSC-Exos are an alternative to MSC-based therapy for regenerative medicine. We review MSC-Exos and their therapeutic potential for a variety of diseases and injuries.

Keywords: Exosomes, Mesenchymal stem cells, Cell-free therapy, Regenerative medicine, Mesenchymal stem cell-derived exosomes, Extracellular vesicles

Core tip: Mesenchymal stem cell-derived exosomes (MSC-Exos) contain a variety of functional proteins, mRNAs, microRNAs, and signaling lipids. MSC-Exos are more stable than their parent cells and do not have the safety issues of living cells, such as tumorigenesis and occlusion of the microvasculature. MSC-Exos represent an alternative to MSC-based therapies for regenerative medicine. In this review, we summarize the characteristics of MSC-Exos and highlight their functions and therapeutic potential for tissue/organ regeneration and for kidney, liver, cardiovascular, neurological, and musculoskeletal diseases, as well as cutaneous wound healing.