Mesenchymal stem cells-derived exosomes as plausible immunomodulatory therapeutic tool for inflammatory diseases

Muhammad Zubair ¹ Fatma A. Abouelnazar ¹ Muhammad Asad Iqbal ² Jingyun Pan ¹ XuWen Zheng ¹ Tao Chen ¹ Wenming Shen ¹ Jinnan Yin ¹ Yongmin Yan ¹ Pengjun Liu ^1* Fei Mao ^2* Ying Chu ^3*

• ¹ Changzhou Wujin People's Hospital, Changning, China
• ² Jiangsu University, Zhenjiang, Jiangsu Province, China
• ³ Xuzhou Medical University, Xuzhou, Jiangsu Province, China

Mesenchymal stem cells derived extracellular vesicles (MSC-EVs), especially exosomes are considered to have diverse therapeutic effects for various important diseases. MSCs-derived exosomes (MSCex) provide substantial advantage over MSCs by their long time preservation, stability, absence of nuclei and fewer adverse effects such as infusion toxicity; hence paving the way towards regenerative medicine and cell free therapeutics. These exosomes harbor several cellular contents such as DNA, RNA, lipids, metabolites, and proteins facilitating drug delivery and intercellular communication. MSCex have the ability to immuno-modulate and trigger the anti-inflammatory process hence, playing key role in alleviating the inflammation and enhancing tissue regeneration. In this review, we addressed the anti-inflammatory effects of MSCex and the underlying immuno-modulatory pathways. Moreover, we discussed the recent updates on MSCex in treating specific inflammatory diseases such as arthritis, inflammatory bowel disease (IBD), respiratory diseases including asthma and acute respiratory distress syndrome (ARDS), neurodegenerative, and cardiac diseases. Later, we discussed the challenges in using MSCex as the successful therapeutic tool and future perspectives.