Exosomes vs Stem Cells | Dr. David Greene Arizona

Over the past few years, we have seen the popularity of exosomes rise exponentially. Why? In order to answer that question, first, we need to define what exactly an exosome is and what they do.

Exosomes are called extracellular vesicles. They originate from within cells and include microRNA, DNA, various proteins, and other “cargo” that are vital for cell to cell communication. As Dr. David Greene Arizona mentioned, exosomes are not cells by themselves and are very small, usually about 40 nm in size.

All cells release extracellular vesicles, and only some of them are actually exosomes. The ones that are extremely popular in regenerative medicine are the ones released by mesenchymal stem cells. These extracellular vesicles (EVs) contain the DNA, RNA, and proteins that are relevant to regeneration and repair processes.

When an exosome is released from a stem cell, it will migrate in the body. It will become attracted to cells with active inflammation, and become ingested. Once that occurs, an exosome will then release its cargo “payload”. These proteins, RNA, and DNA work through a complicated cell to cell interaction process to amp up regeneration processes, added Dr. David Greene. This can be amazing for wounds, blood supply, immune modulation, cell reprogramming, cell survival and proliferation, and a slew of other functions. Just look at this illustration!

In the world of regenerative medicine, exosomes have a LOT of benefits. Here are the Top 5 reasons:

1. They are very small, so it doesn’t matter what size the needle is used. Exosomes are highly functional no matter whether a 32 gauge needle is used! This has made them extremely popular in aesthetics, such as for hair restoration, facial rejuvenation, and sexual wellness procedures.
2. Exosomes are so active in the cell to cell communication, that a lot of providers use them exclusively without stem cells. Why? They will say that exosomes are a way of skipping the stem cell “middleman”! 
3. We see quite a few providers using a 1-2 punch. This involves using exosomes to gain an immediate benefit, and then umbilical cord stem cells to provide a more sustained effect.
4. Exosomes are becoming more cost-effective for regenerative procedures. For instance, one of the top exosome companies, Regen Suppliers, offers a product called ReBellaXO including two 1cc vials for only $675 ($337 per cc)!
5. Storage – exosomes are fine being cryopreserved, but it’s actually not necessary. They can be stored in a regular freezer and be fine, even after a month of storage!
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Research studies are showing just how effective exosomes can be. There are studies worldwide showing the effectiveness of exosomes for kidney failure, arthritis, autoimmune conditions, liver failure, and many more. Of note, the FDA has not approved exosomes for any particular indication, so that needs to be mentioned, added David Greene Orthopedic. That doesn’t preclude their use in the US though.

When looking at exosome usage versus stem cells, there are a few differences to note. According to David Greene MD, founder and CEO of R3 Stem Cell, Stem cells are significantly larger than exosomes, so you need to be careful when using a needle larger than 25 gauge as it will lyse the cells. Also, cryopreservation is critical for stem cell viability. They should only be thawed out right before use.

In addition, stem cells also participate in a lot of cell to cell communication. Whether they are alive or not in a recipient, they can release exosomes that may be extremely beneficial. It is still unknown which provides a more sustained effect in the body, or whether the combination is better.