Exosomes are micro-vesicles involved in cellular communication being positioned as a new frontier in regenerative medicine. They are involved in direct cellular signaling. Exosomes are isolated from human mesenchymal stem cells; and bring a wide array of growth factors. The present understanding is that the exosomes activate the patient’s own regenerative process by influencing the cellular response just as a hormone effects a distant organ. Those who regularly read this Blog will be reminded that in order to meet FDA guidelines, orthobiologics must be autologous (come from the same individual in which they are used), and can not be expanded or mixed with other biologics. Exosomes may be a way of providing the patient with a very diverse and large quantity of growth factors and bypass the FDA guidelines regarding using cells from sources other than the patient.
Stem Cells work to heal, repair and restore the body. They do so by producing micro-vesicles called exosomes and thus signal nearby cells to change behavior. Since the FDA does not allow us to use stem cells from outside our own body, might the exosomes from stem cells outside of our body comply with FDA guidelines, and provide sought after outcomes? Could a patient with advancing arthritis experience and enjoy pain relief, improved function, postpone or avoid a joint replacement and enjoy a high degree of activity via a course of exosomes?
As you age, your stem cell numbers are known to diminish and that is why the orthobiologic quest is for approaches that will prove successful in any decade of life. As of this time in my practice, after the patient intake and review of images, I provide an informed consent as to what nature of intervention will best meet the needs of my patients. My mainstay has been Bone Marrow Concentrate; but from time to time I will introduce the option of Growth Factors recovered from your own circulating blood. Then there is the Micro-fractured adipose tissue option for those who I feel would be best served by the latter approach. Should I introduce Exosomes into my menu of services?
I am still in the Safety and Efficacy evaluation of the Exosome option so make sure you return to my Blog in the future to learn more. To schedule a consultation call (847) 390-7666. You may visit my web site at www.sheinkopmd.com