Stem cell therapy has continued to be one of the most exciting fields in the medical sciences. Recent advancements have centered on exosomes (or ‘extracellular vesicles’) which are released by stem cells, effectively increasing the geographic range over which stem cells can act.
Autologous stem cell therapy, in a nutshell, involves extracting cells from your body (e.g. from bone marrow or fat), spinning it through a centrifuge to get a concentrate, and then administering that cocktail of cells back into a target area of the body. Allogenic stem cell therapy is similar with one key difference — the donor and recipient of stem cells are not from the same individual.
Regardless of the source, once stem cells are reintroduced, they assume the role of conductor over a complex set of interactions involving many cell types, all with one purpose — to repair damaged tissue. So how do stem cells conduct this symphony? By secreting exosomes to communicate with other stem cells as well as all other cell types in the body.
What are Exosomes?
Elucidating the molecular mechanisms and how exosomes work remains a work in progress. In short, exosomes are little pieces of data that a cell produces to communicate with other nearby cells. Each cell in the body secretes and accepts exosomes, making it the universal biological language. (https://dev.biologists.org/content/143/14/2482)
(https://www.sciencedirect.com/topics/medicine-and-dentistry/exosome) Measuring only 30 to 150 nanometers in size, describing exosomes as small is an understatement. But the cargo they help transport — including RNA and proteins — from one cell to another is vitally important for modifying the behavior of the receiving cell. In doing so, millions of cells can be made to work together in a group as opposed to each doing its own counterproductive thing.
Why are exosomes becoming popular?
As is true in many other fields, the new kid on the block typically garners a lot of attention. Exosomes and their role in regenerative medicine are a relatively new and exciting discovery. As such, they’ve caught the public eye as well as the attention of regenerative specialists.
Exosomes appear to be effective at what they do — synchronize behavior of groups of cells and making them more responsive to the needs of neighboring cells. Instead of cells unknowingly working against each other, they begin to pull in the same direction and repair damage — physical or functional.
The risk that typically accompanies allogenic stem cell therapy has yet to be seen with exosome therapy. For example, sensitivity can manifest over the long term with repeated allogenic stem cell therapy — this has not yet been demonstrated with exosome therapy.
Are Exosomes better than Stem Cells?
Wrong question!! Exosomes should not be regarded as a replacement for stem cells. Exosomes are a tool stem cells use. In some instances, that tool might be all the job calls for. However, taking away the brains of the operation — i.e. stem cells — might not be wise as the job may call for other tools beyond just exosomes. Instead, exosomes may be thought of as a force-multiplier, there to augment certain behavior of stem cells but not to assume the role of the conductor outright. A well trained physician can help you decide if exosome therapy alone, stem cell therapy alone, or a combination of the two makes the most sense for your specific circumstance.
How Much Does Exosome Therapy Cost?
It depends on several factors.
Not all procedures are created equal in terms of complexity and skill level required of the physician. Spinal procedures in particular tend to be pricier than say peripheral joint injections (e.g. knee, elbow, etc).
The labs from where exosomes are sourced are of varying quality. Those with legitimate reputations that respected physicians prefer to work with carry a premium price tag. At the other end of the spectrum, there are some labs willing to compromise quality in favor of price. A trusted relationship with your physician is paramount.
Quantity of exosomes used matters. Some injections warrant small volume injections whereas others call for more exosomes. In essence, the more you use, the higher the price.
Having said the above, expect to pay somewhere in the range of $5,000 to $10,000.
Do Exosomes Work?
Many stem cell companies have placed great importance and funding on exosome research. There are also efforts underway into creating exosome-based drugs.
The size of exosomes plays a factor in their efficacy, allowing them to easily reach a target site intact with their lipid-protected cargo and initiate the healing response.
Exosome therapy appears to be helpful in promoting cellular regeneration and restoring function that was once deemed impossible to achieve. More work is being done to explore the ideal method of employing this technology for degenerative diseases, pain, and injury. Preliminary data certainly points to a very promising future for exosomes.
Regardless of the biological therapy in question — i.e. allogenic stem cell, autologous stem cell, or exosomes therapy — the most crucial factor is that it is best done under the care of a highly trained and accessible medical physician (MD or DO). In untrained hands, any of these tools can become instruments of injury rather than healing. If the best trained physician is not accessible to help you with your particular needs and questions before the procedure, then you will not receive the care you deserve following the procedure. So, again, choice of physician is of paramount importance when determining your prospect for success.
By Vasilly Eliopoulos and Khoshal Latifazai, Founders of Rocky Mountain Regenerative Medicine, is the only full-service integrative and regenerative medicine clinic of its kind in the nation specializing in Exosome Therapy.
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