Exosome – Rejuvenation Treatment
Our body consists of 200 different types of cells. Among them, only stem cells have the ability to produce other cell types. Exosomes, a kind of small messengers, carry important messages to target cells. Exosomes, which have a very small particle structure with a diameter of 30-200nm, are approximately 1/1000 of the size of the cell. They travel between cells and transfer growth factors responsible for tissue repair and immune modulation.
Extracellular vesicles or bubbles released from stem cells are called exosomes. Exosomes, which are important for the body, are extracellular particles responsible for genetic information and enable communication between cells. The size of exosomes, which are the main regulators and carriers of intracellular information between both nearby and distant cells, is 30-150 nanometers. Thanks to these small sac-shaped structures excreted by cells, DNA, RNA and proteins are transferred from one cell to another.
Exosomes go into the cell and fix the faulty or missing cell parts there, allowing them to function just like in youth. Exosome therapy is a treatment technique that rejuvenates cells.
- Blemish and acne scar treatments,
- Hair loss, eczema and atopic dermatitis
- Aesthetic facial rejuvenation and wrinkle removal
- To create vitality and brightness on the face
- Treatment of facial scars such as chicken pox and acne
Exosomes stand out with their functionality in areas such as skin repair, skin rejuvenation and inflammation reduction in the body. Although stem cell structures are responsible for the rejuvenation of old cells, there is a risk that these cells cannot provide all the information the body needs. In this case, it is possible to provide new pieces of information with the exosome function in order to support the body’s healing process and make the treatment much more effective.
- The majority of the beneficial effects of stem cell therapy are due to cell-derived immunosuppressive, angio-modulatory and some trophic factors.
- The therapeutic use of stem cell-derived “secretome” currently stands as a powerful alternative to cell-based therapy.
- Stem cell-derived secretome contains many bioactive molecules found in extracellular vesicles (EV).
WHAT DOES THE SECRETOME DO?
In many clinical studies, it is thought that the effect of stem cells is not caused by the cells, but by other substances such as vesicles, protein molecules and cytokines released by the cells.
These substances released to the outside are generally called “secretome“. Which substances of the secretome trigger the actual effects are still largely unknown.
Basic biological function of extracellular vesicle EVs
The basic biological function of all extracellular vesicles (EVs):
- Communicating from cell to cell
- EVs are found in all biological fluids in our body (blood, urine, breast milk)
- Exosomes easily penetrate tissues with their nano dimensions and reach all target cells
- It has paracrine and endocrine effects
EVs (Extravesicles) are divided into 3 groups according to their size;
- Apoptotic bodieslargest (>1000 nm)
- Micro-vesicles (100–1000 nm)
- Exosomes (30–200 nm)
Exosome New Generation Cell Therapy
Exosomes released by young stem cells have an important effect in regulating regenerative processes in the body. Although exosomes are not cells, they play a critical role in communication between all cells in the body and cell rejuvenation.
Aging, chronic diseases, environmental factors and genetic disorders can disrupt the healing process by interfering with how stem cells communicate with other cells. Exosomes are one of the new generation cellular therapies because they play a critical role in regulating these communication processes.
Exosome contains 50 different growth factors and 3 different cytokines. (proteins and peptides that enable cells to communicate with each other)
Exosome is a procedure performed without the need to take abdominal fat or bone marrow from the patient.
It is a treatment that is more practical than other stem cell methods and involves the secretions of stem cells grown in a laboratory environment.
Thus, the reparative cells in the applied area are virtually re-coded, ensuring a more accurate repair.
Exosome in Musculoskeletal System Diseases
Although exosomes are one thousandth the size of cells, they strengthen the functions of the cells they affect and play a role in cell repair. In this context, they deliver DNA, RNA, growth factors and amino acids to the cell they will repair. In addition to the treatment of orthopedic injuries and various degenerative diseases, exosome therapy is frequently used due to its anti-aging properties.
Exosome Must Be Transported in Cold Chain
Products to be used in exosome treatment must be transported in the cold chain and used without waiting after opening. Before starting exosome treatment, a local anesthetic cream is applied to the application area and expected to take effect. The injection is then performed. Due to the effect of local anesthesia, no pain or pain is felt.
Exosome must be in high concentration
For exosome treatment to be successful, the injected exosomes must be highly concentrated. Within the scope of exosome treatment, the dense mixture injected into the application area includes components such as Q enzyme, minerals, peptides, around 50 growth factor amino acids and vitamins. The dosage of the mixture to be injected within the scope of exosome treatment is determined for each patient, according to the needs of the treatment area and the treatment plan.
Exosome is an easy treatment
Exosome treatment is an extremely comfortable procedure for the patient. There is no change in the patient’s daily life. Depending on the injected dose, it is possible for fibroblast cell proliferation to increase up to 80%, elastin synthesis to 3 times and collagen synthesis to 6 times with treatment.
Obtaining Exosomes
DNA, RNA, amino acids and hundreds of growth factors are contained in exosomes used in exosome treatment. To obtain exosomes from stem cells, first the stem cells in culture are grown. Exosomes are then purified from the liquid medium containing the stem cells grown in culture. In the next step, it is freed from stem cells and pure exosome is obtained.
Exosome Rejuvenates Old Cells
Research has given us invaluable insights into the practical functionality of exosomes. By exposing cells of an old organism to cells of a young organism, exosomes from young stem cells have been shown to be responsible for rejuvenating old cells. This healing mechanism has now begun to be used in regenerative medicine.
Regenerative Effect of Exosome Similar to Stem Cell
Degenerative diseases result from continued cell deterioration affecting tissues or organs. Although stem cells are generally responsible for the rejuvenation of cells, some external factors can inhibit this function. It is possible to accelerate the healing and regeneration process by supporting the functions of stem cells with externally supplied exosomes.
Exosomes Calm the Overreactive Immune System
Exosomes contain proteins and valuable genetic cell information that cells need to function properly. Stem cell-derived exosomes have been shown to help transfer this information to NK (Killer cells) and T-Regulatory (Helper) cells. Thus, it helps calm an over-reactive immune system and modulate it to respond in a coordinated manner.
What's inside exosomes?
- 50 different growth factors;
Hyaluronic acid synthesis
Stimulation of dermal renewal
Increase in the number of fibroblasts
Increased cell division rate
Provides epidermal renewal. - 3 different anti-inflammatory cytokines
Wound healing
Soothing the skin after laser
Restoring the skin’s barrier function - 96 types of mRNA for skin renewal
Anti-inflammatory effect
Anti-aging effect
Removing skin blemishes
Epidermal Regeneration - 184 proteins that renew the skin
Wound healing
Anti-apoptosis (prevention of cell death)
Epidermal Regeneration,
Elasticity (Collagen-Elastin synthesis)
Exosome Mechanism of Action
They change cell behavior by transferring some genetic information, proteins and receptors between cells. Thanks to these properties, they are effective in cell proliferation and tissue regeneration. They reduce inflammation by suppressing inflammatory proteins and stimulating anti-inflammatory proteins. They ensure regeneration by stimulating the proliferation and migration of fibroblasts, endothelial cells, keratinocytes and specific endogenous progenitor cells (progenitor cells) to the damaged area.
Exosomes can increase Fibroblast cell proliferation by up to 80% depending on the dose. Exosomes can increase Collagen synthesis by 6 times depending on the dose. Exosome can increase Elastin synthesis by 3 times depending on the dose.
In the studies carried out; Exosomes obtained from mesenchymal stem cells have been shown to reduce apoptosis (programmed cell death) that occurs in tissues damaged as a result of disease or injury. They ensure tissue regeneration by increasing the normal cross-collagen bond structure. They reduce scars and provide healing closer to normal tissue.
How to Obtain Exosome?
Cells obtained from newborn umbilical cord tissue are grown in special culture dishes with a cell-specific medium. Dead cell residues are removed from the culture medium of the replicated cells. After pretreatment steps, exosomes are isolated by high-speed spinning (ultracentrifuge). After passing quality control tests, the obtained exosomes are turned into products and stored under appropriate conditions.
When is the effect of Exosom seen?
In order for the effect of exosome treatment to be seen, the cells must be waited to complete their self-renewal process. The time period in which this process will be completed and when the results of exosome treatment will be seen may vary depending on factors such as the patient’s age, the degree of the problem to be treated, and the patient’s current health condition.
The most important reason for this is that the body begins to respond more slowly to stem cell signals due to various factors as we age. It takes a certain amount of time for the body to repair itself. Therefore, a period of approximately 3 months must be waited for the results of exosome treatment to appear.
Advantages of Exosomes
- There is a very small risk of tumor development in the use of embryonic stem cells, but since exosomes do not have the ability to proliferate, such a risk does not exist. Therefore, it should be known that exosome therapy is extremely safe.
- They do not cause tissue rejection. They are suitable for allogeneic use.
- Exosomes are not cells and are smaller than cells in size.
- The most important difference from adult stem cells is that they are obtained from a newborn.
- In addition, they have a high potential for clinical and aesthetic use, thanks to the many more growth factors they contain.
- Since they contain protein, they can last longer without deteriorating their main structure when appropriate conditions are provided.
- It is a superior product to autologous treatments as it does not require any surgical procedure during its production.
- They come in a vial that can be directly injected. In this way, there is no possibility of complications.
- They can be administered intravenously, intramuscularly, locally or by injecting into the skin.
Properties of Exosomes
By coordinating communication between different cell types, exosomes are involved in many physiological and pathological processes, including tissue damage and repair responses. They act as vectors between different cell types, transferring nucleic acids, proteins or lipids to target cells, causing changes in the phenotype and function of target cells. More than 41,860 proteins, 7,540 RNAs and 1,116 lipid molecules have been identified in exosomes.
Exosomes can travel throughout the body via the circulatory system and cross the blood-brain barrier and other tissues to be taken up by target cells.
These extracellular signals are transmitted from exosomes to recipient cells in 2 ways:
- Receptor-ligand binding
- Membrane fusion
Composition of Exosomes
The exosome is a complex of many proteins that functions as an RNA exonuclease. It has an important role in the degradation of RNA in the cells of eukaryotic organisms. It is important for rRNA, snRNA, snoRNA maturation, RNA quality control, and intracellular mRNA degradation. The human exosome contains 9 subunits called the “core” and some accessory proteins; They mainly consist of exonucleases, helicases or RNA-binding proteins.