Aug 2026· Stem Cell Research & Therapy· 0 citations
TL;DR
This comprehensive review summarizes current research on SC-exosomes in renal diseases, with emphasis on their biological characteristics, therapeutic mechanisms, preclinical evidence, and translational challenges.
Abstract
Chronic kidney disease (CKD) represents a growing global public health challenge. Current treatments, including pharmacological therapy, immunosuppression, and renal replacement therapy, mainly aim to slow disease progression rather than restore damaged renal tissue, and their efficacy remains limited in many patients. Although stem cell-based therapies have shown regenerative potential, their clinical application is constrained by poor cell survival, limited engraftment, immunogenicity, and potential safety concerns. Stem cell-derived exosomes (SC-exosomes) have therefore attracted increasing attention as a potential cell-free therapeutic strategy. These nanoscale extracellular vesicles can transfer bioactive cargoes, including proteins, lipids, messenger RNAs (mRNAs), and microRNAs (miRNAs), to recipient cells and thereby mediate intercellular communication. Compared with parental stem cell transplantation, SC-exosomes may offer several advantages, including lower immunogenicity, reduced tumorigenic risk, relative stability, and the potential to cross certain biological barriers. This comprehensive review summarizes current research on SC-exosomes in renal diseases, with emphasis on their biological characteristics, therapeutic mechanisms, preclinical evidence, and translational challenges. SC-exosomes may contribute to renal repair by promoting cell survival and regeneration, suppressing inflammation, apoptosis, oxidative stress, and fibrosis, and modulating immune and microvascular responses. We also discuss their potential relevance in multiple renal conditions, including acute kidney injury (AKI), CKD, diabetic nephropathy (DN), and other kidney diseases, as well as the use of exosomal cargoes as candidate diagnostic or prognostic biomarkers. Finally, we outline emerging opportunities and unresolved challenges in this field, including engineered exosomes, targeted delivery, exosome heterogeneity, dose optimization, large-scale production, purification, quality control, and long-term safety. Further standardized preclinical studies and well-designed clinical trials are needed before SC-exosome-based approaches can be translated into routine clinical application.
Exosomes have a high translational potential for the diagnosis and treatment of kidney diseases, and this review provides a roadmap for bridging preclinical findings to clinical practice.
Juan He, Jianan Feng, Jin Zhao et al.· Nephrology, Dialysis and Tra...· 0 citations
As the largest organ of the human body, the skin is essential for maintaining systemic homeostasis; however, it remains highly susceptible to injury and wound formation, posing a significant clinical and economic burden. Wound healing is a complex, tightly coordinated process that progresses through overlapping phases of hemostasis, inflammation, proliferation, and tissue remodeling. Exosomes, nanoscale extracellular vesicles (50–150 nm in diameter) secreted by various cell types, have emerged as critical mediators of intercellular communication. Laden with bioactive molecules such as proteins, RNAs, and lipids, exosomes can partially replicate the regenerative functions of their parent cells. Among various types of exosomes, mesenchymal stem cell-derived exosomes (MSC-Exos) have become the most clinically translatable research direction in the field of skin wound repair due to their biological functions similar to those of their parent stem cells, low immunogenicity, and advantages as a cell-free therapy. This review focuses on MSC-Exos and systematically summarizes the roles and underlying mechanisms of adipose-derived stem cell exosomes, bone marrow mesenchymal stem cell exosomes, human umbilical cord mesenchymal stem cell exosomes, antler stem cell exosomes, human urine-derived stem cell exosomes, and induced pluripotent stem cell exosomes in cutaneous wound repair. Additionally, to broaden the diversity of therapeutic sources, plant-derived exosome-like nanovesicles are also discussed as an emerging perspective. Current evidence indicates that these vesicles facilitate wound healing and attenuate scarring by modulating multiple signaling pathways, thereby promoting cell proliferation, migration, angiogenesis, and extracellular matrix remodeling. Nevertheless, challenges in isolation, purification, optimization, standardization, and quality control continue to hinder their broad clinical translation. Despite these obstacles, exosomes represent a promising therapeutic strategy for cutaneous wound healing.
Yi-Hang Li, F. Zheng, Ya-Juan Bai et al.· Frontiers in Immunology· 0 citations
Diabetic nephropathy (DN) remains a major cause of end‐stage kidney disease. Stem cell‐derived exosomes have emerged as a promising therapeutic strategy due to their ability to deliver bioactive molecules to damaged tissues. This narrative review, conducted in accordance with PRISMA guidelines, aims to evaluate the therapeutic potential of exosomes derived from various stem cell sources, including mesenchymal stem cells (MSCs), embryonic stem cells (ESCs), and induced pluripotent stem cells (iPSCs), in the context of DN. A comprehensive literature search was performed using relevant databases (e.g., PubMed, Web of Science, Scopus) to identify preclinical and clinical studies investigating the effects of stem cell‐derived exosomes on DN. The identified studies were assessed for quality and methodological rigor. Priority was given to high‐impact studies and those with robust experimental evidence. The selected literature was synthesized thematically to provide a coherent overview of the current state of research on exosome‐based therapies for DN, highlighting current findings, and future directions. Results from preclinical studies suggest that exosomes derived from different stem cell sources can exert reno‐protective effects, including reducing inflammation, fibrosis, and oxidative stress. However, comparisons between different exosome types indicate that MSCs‐derived exosomes (MSC‐Exos) may offer superior therapeutic benefits. While clinical trials are ongoing to evaluate the safety and efficacy of stem cell‐derived exosomes in DN patients, further research is needed to optimize exosome production, delivery, and therapeutic efficacy.
Mo Li, Tianjing Sun, Allen C. Gao et al.· Stem Cells International· 0 citations
Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide despite advances in screening, surgical techniques, and systemic therapies. In recent years, exosomes—nanoscale extracellular vesicles involved in intercellular communication—have emerged as critical regulators of CRC biology. Exosomes mediate tumor progression, metastatic dissemination, immune evasion, and therapeutic resistance through the transfer of bioactive molecules including proteins, lipids, and non-coding RNAs. Moreover, exosomes have gained increasing attention as promising liquid biopsy tools and therapeutic platforms due to their stability, biocompatibility, and ability to reflect tumor molecular dynamics. This review provides a comprehensive overview of exosome biogenesis, molecular composition, and their functional roles in CRC pathogenesis. We further discuss their diagnostic and prognostic value, involvement in therapeutic resistance, and emerging therapeutic applications, with particular emphasis on translational and surgical oncology implications. Finally, we highlight current limitations and future perspectives for clinical integration of exosome-based strategies in CRC management.
Mesenchymal stem cells (MSCs) and regulatory T cells (Tregs) form a key immunoregulatory axis essential for maintaining immune homeostasis and treating autoimmune diseases, transplant rejection, and inflammatory disorders. Although both MSCs and Tregs have been individually studied, a clear synthesis of how MSCs regulate Treg function across distinct mechanistic layers and disease contexts remains lacking. MSCs regulate Treg differentiation, expansion, and functional stability through paracrine signaling, intercellular contact–dependent pathways, extracellular vesicle (EV)–mediated transfer of microRNAs (miRNAs) and proteins, mitochondrial transfer, and metabolic and epigenetic reprogramming. These mechanisms restore Th17/Treg balance, suppress inflammation, and promote tissue repair. Preclinical studies demonstrate strong therapeutic potential in multiple immune–mediated diseases; however, clinical translation remains limited. Unlike previous studies, this review integrates soluble and exosomal signaling pathways, compares shared and disease‐specific regulatory mechanisms, and critically evaluates MSC source variability, methodological limitations, and causes of clinical inconsistency. It aims to provide a conceptual framework to guide future mechanistic studies and clinical development of MSC–Treg–based therapies.
Background: Degenerative diseases place an immense burden on global healthcare. Stem cell-based regenerative medicine offers transformative, potentially curative therapies to restore damaged tissues and recover normal physiological function. Aim: This review aims to comprehensively evaluate the therapeutic applications, biological mechanisms, and clinical prospects of stem cells in treating diverse human organ disorders. Methods: We conducted a comprehensive literature review of preclinical models and clinical trials focusing on mesenchymal (MSCs), hematopoietic (HSCs), and pluripotent stem cells (PSCs), evaluating their efficacy, safety, and manufacturing challenges. Results: Cell therapies demonstrate remarkable healing potential. MSCs exhibit potent immunomodulatory effects in inflammatory conditions. HSC transplantation remains the gold standard for hematological disorders and is expanding into targeted gene therapies. PSC-derived cells show promising clinical efficacy in spinal cord injuries, macular degeneration, type 1 diabetes, and heart failure. However, significant hurdles remain, including immune rejection, tumorigenicity, and batch-to-batch variability. Conclusion: Cell therapies represent a paradigm shift from lifelong symptom management to definitive cures. Resolving biological, technical, and regulatory hurdles is imperative for the safe, standardized, and widespread clinical translation of these interventions. Relevance for Patients: For patients suffering from chronic, degenerative, or currently incurable conditions, stem cell therapies represent a transformative clinical paradigm. By facilitating functional tissue regeneration and targeted immunomodulation, these therapies reduce the burden of chronic pharmacotherapy and invasive procedures.
Somayeh Shamlou, Hossein Rostami, Ali Hassanzadeh et al.· Journal of Clinical and Tran...· 0 citations
