Exosomes are the new trend in the medical field. Touted as a cure-all for diseases ranging from acne and aging skin to neurological diseases such as Alzheimer’s and Parkinson’s, exosomes come with a hefty price tag of over thousands of dollars. However, there is a catch— we don’t know how exosomes work, or even what these tiny blobs of trendy treatment are.
Exosomes are tiny blobs that bud off from cells, like those of the umbilical cord and salmon testicles, and have different contents present in them. Even cell biologists are unsure of how beneficial—or dangerous —exosomes are. Typically, exosomes are administered by injection or spray.
Exosome treatments have not yet undergone rigorous trials. The US, UK, parts of Europe, South Korea, and Japan have seen an explosion in the use of exosome-based products, despite the absence of medical approval in these countries. The global market for exosome skin-care products was valued at $256 million in 2023 and is projected to grow to $674 million over the next six years, despite being a relatively new concept in the medical world.
At first, exosomes were viewed as “trash bags” of the cell, pinched-off portions of the cell that shuttled out waste products. However, new evidence suggests that exosomes might be acting as a “middleman” in signaling pathways. For example, cancer cells may utilize these exosomes to send signals that facilitate tumor growth. The mystery surrounding what exactly is present inside exosomes remains prevalent. Cell biologists believe that exosomes contain proteins, lipids, and other biomolecules that are produced during cell metabolism. Some scientists claim that they also contain DNA and RNA. However, not everyone is convinced.
Exosomes are small, approximately 70 nm in width, making it challenging to analyze their contents. Other than that, there is hardly any information about when exosomes are released by cells. Most cells release exosomes at a steady pulse; some release a lot of exosomes, like immune cells, while others release a smaller number of exosomes, like cancer cells. However, scientists have no idea why this is the case, says James Edgar, who studies exosomes and similar vesicles at the University of Cambridge in the UK.
Many cpare selling exosomes derived from human cells, including those from the umbilical cord and placenta, while others are selling exosomes acquired from plants and animals. Clinics around the world define exosomes as cosmetic products. However, practitioners using exosomes are not allowed to make claims about the health benefits of exosome treatments.
Dev Patel, who holds a medical degree and a postgraduate diploma in dermatology, utilizes exosomes at his “anti-aging and skin rejuvenation” clinic, Perfect Skin Solutions, in the UK. In his eyes, customers are less interested in treatments that merely give the impression of youth, but are more drawn to methods that actually rejuvenate the skin. Naturally, the patients have caught on to the benefits of exosomes.
Previously, Patel used unapproved exosomes derived from human fat cells, which were prohibited from sale in Europe. However, Patel had already used it before knowing the regulations surrounding exosomes derived from human cells. Patel stopped using the product and had a stock of around $6500 worth of exosomes when he realized that those he used were illegal. Now, he has shifted to using exosomes developed from salmon testes and plant cells. For hair regrowth, Patel provides a course of five exosome treatments. For skin treatments, he recommends two to three sessions, with additional sessions for de-aging treatments. For baldness treatments, Patel uses four sessions of exosome treatment every week, and the results are excellent.
Although Dev’s account affirms the positive effect of exosomes, another patient found no reduction in acne scarring after trying out exosome treatment as a participant in a trial. She underwent three treatments, in which her face was numbed and microneedled, before the exosomes generated from the umbilical cord were administered. She found the results underwhelming, given the promise it held.
While the effects of exosomes are debated, the safety of the treatment raises its own concerns. According to Ke Chang, who is researching the use of engineered exosomes for cardiac diseases, exosomes are considered safer than stem cell therapies, as they consist of non-living biomolecules, as opposed to stem cell treatments, which involve living cells. Exosomes are less likely to trigger an immune response or cause cancer, as exosomes don’t replicate. However, since the exosome market is currently unregulated, there is a risk of sourcing exosomes using various methods, which may pose safety and ethical concerns.
The exosome hype has gone beyond beauty, and a significant number of exosome clinics promise effects against long COVID-19, and others claim it can cure sports injuries and treat Alzheimer’s. Promising studies have been conducted in test animals, but this is still far from a trial that the FDA can recognize and approve as a product.
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