Plastic Surgery Update on the Mesenchymal Stem-Cell Derived Extracellular Vesicles towards Cell-Free Therapeutic Applications

Abstract

In the biogenesis of extracellular vesicles (EVs), exosomes and other lipid-lined vesicles are released upon fusion of multivesicular bodies with the cell membrane of stem cells. EVs contain a diverse number of growth factors, cytokines and bioactive molecules of proteins, lipids, microRNA, and mRNA that mediate cell-cell communications for homeostasis, immune signaling, angiogenesis, anti-inflammation, senescence, proliferation, and differentiation. To further explore its potential usages, plastic surgeons are beginning to show an increased interest in this novel cell-free therapy to partially explain the paracrine effects of cell-based therapies on cell repair, tissue engineering, and aesthetic rejuvenation. The burgeoning preclinical and clinical experience appears to be promising, but current in vitro studies, translational research, and IRB-registered investigations emphasize the need to clarify product identification/purity, attributed biologic functions, standardized protocols, and applications to advance basic science findings and provide beneficial safe clinical outcomes. Since the specialty of Plastic Surgery is committed to advancing evidence-based stem cell studies in compliance with FDA regulations, an updated review of EVs is timely to provide insights to achieve these goals.