The role of MSC-derived exosomes in immune modulation and regenerative medicine

Mesenchymal stem cell (MSC)-derived exosomes have emerged as promising cell-free therapeutic agents in immunomodulation and regenerative medicine. These extracellular vesicles transport bioactive lipids, proteins, and nucleic acids that mediate intercellular communication.

This narrative review summarizes current strategies for isolating MSC-derived exosomes, including ultracentrifugation, size-exclusion chromatography, and immunoaffinity capture, and evaluates their functional cargo and therapeutic applications.

MSC-derived exosomes exhibit potent immunomodulatory effects, including suppression of pro-inflammatory cytokines, expansion of regulatory T cells, and promotion of anti-inflammatory microenvironments. They demonstrate therapeutic potential across autoimmune, cardiovascular, oncologic, and neurodegenerative disease models. Engineered exosomes further show promise as targeted drug-delivery systems, particularly in oncology, by enhancing drug bioavailability and overcoming chemoresistance. Compared with MSC-based therapies, exosomes offer advantages such as reduced safety concerns and improved stability.

By integrating cargo-specific immune modulation with organ-specific regenerative outcomes, MSC-derived exosomes represent a versatile therapeutic platform. Standardized purification methods and further clinical studies are essential to advance their translational and clinical applications.