The development of exosomes as therapeutic agents has been widely explored. Their potential has been acknowledged in various research fields such as regenerative medicine and oncology. Exosomes are nanovesicles that are actively secreted by multiple cell types. Their primary role is to act as mediators of extracellular communication between the body and its environment.  

They’ve been used to deliver various molecules such as drugs and proteins. Therefore, this article aims to provide you with the current state-of-the-art innovations in using exosomes for better musculoskeletal health.  

  • Engineered Exosome For Muscular Therapy 

In contrast to stem cell treatment, engineered exosomes therapy doesn’t need the use of donor cells from inside your body. Instead, exosomes are isolated and sterilized from donated human mesenchymal stem cells (MSCs). 

The exosome solution is rich in beneficial lipids, messenger RNA, microRNA, signaling cytokines, and proteins. Exosome therapy may be delivered intravenously (IV) or directly into the treated region. Since exosomes are potent components that can regenerate cells throughout your body, they facilitate cell-to-cell communication, which is critical for cell health in general. 

Exosomes contain roughly three times the number of growth factors seen in adult stem cells. Increased growth factors imply a greater capacity for regenerating and revitalizing target cells. Therefore, exosome therapy is a particular and adaptable therapeutic modality for illnesses such as osteoarthritis, chronic pain, and musculoskeletal injuries.  

Since genetic problems, chronic and degenerative illnesses, and the aging process may all impair the capacity of your cells to communicate, exosome treatment facilitates communication between cells. Hence, it stimulates healing. 

For instance, osteoarthritis is a widespread kind of degenerative joint disease. While stem cell treatment has rejuvenating properties, its effectiveness may be restricted by external circumstances and your general cell health. On the other hand, exosome treatment promotes recovery by supplying your body with new information from younger cells. 

  • Engineered Exosomes Improve The Development Of Therapeutic Tools 

Exosomes are cellular messengers that can promote the transfer of genes and mRNAs among target cells. Their potential application of engineered exosomes includes the development of diagnostic and therapeutic tools for diseases such as Alzheimer’s, cerebrovascular, and musculoskeletal disorders. 

Not to mention that exosomes are non-invasive and can’t block blood vessels. In contrast to the direct introduction of living cells, exosomes efficiently penetrate the BBB, or the blood-brain barrier, demonstrating distinct benefits in treating brain illnesses.  

They can also cross major blood vessels of the brain without causing significant adverse reactions. They’re also effective at protecting the internal structures of brain cells. Exosomes may be maintained indefinitely at -80 °C, successfully protecting interior soluble components such as biological factors and nucleic acids. 

While unaltered natural exosomes are capable of targeting, they suffer from low targeting efficiency, a short circulation half-life, and limited effectiveness. Numerous engineering techniques may be utilized to change the homing peptides or ligands on the surface of exosomes, endowing exosomes with the capacity to target and thereby increasing their therapeutic efficacy. 

  • Engineered Exosomes In Promoting Muscle Regeneration 

Exosomes could be used as antiestrogenic agents, scaffolds, vectors of drugs, or nanomaterials to treat bone disease. Their development could provide a comprehensive approach to treating the complex musculoskeletal system. 

Thus, exosomes can enhance the bioactive materials of various biotechnological products. They can be initiated by introducing exosomes with a combination of –TCP, PLAG, or scaffolds. 

Exosomes combined with tricalcium phosphate (-TCP), or polylactic-co-glycolic acid (PLGA) scaffolds, bone graft substitutes, enable the slow release of exosomes into regenerating bone tissue and their subsequent uptake by bone marrow MSCs with a variety of beneficial effects. 

They might be utilized as osteoprotective, proosteogenic, or antiosteoclastogenic agents in and of themselves as enhancers of bone scaffolds, as drug vectors, as nanomaterials, or even as a replacement for MSC treatment.  

Additionally, because osseous tissue is a more complex musculoskeletal system component, exosomes could theoretically facilitate a more comprehensive approach to treating bone disease by involving the musculature and nervous system. 

Indeed, exosomes have been engineered to promote muscle health regeneration via angiogenic, antifibrotic, antiapoptotic, and myogenic effects, tendon regeneration, and peripheral nerve regeneration via miR-133b delivery. 

  • Engineered Exosomes For Biomedical Applications 

Exosomes have been studied for their potential in medicine. Currently, they’re being used in various studies related to the development of drugs and tissues. They’ve also been shown to play critical roles in spreading infectious agents. 

Exosomes have been extensively investigated because of their potential in medicine. They have been employed in several investigations for tissue regeneration, medication and gene delivery, and disease diagnostics.  

Naturally, in addition to their well-known function in cell-to-cell communication, recent research has shown that exosomes also play a role in transmitting numerous infectious pathogens, including the human immunodeficiency virus (HIV), Epstein–Barr virus (EBV), and prions. 

Exosomes generated from various cells have distinct characteristics, compositions, and impacts on their target cells. Furthermore, exosomes inherit the features of their mother cells. These two primary characteristics of exosomes may have a plethora of biological uses. For example, researchers employ exosomes generated from mesenchymal stem cells (MSCs) in regenerative medicine to promote tissue regeneration and wound repair. 

They have a wide variety of functional molecules and proteins, and their molecular composition can vary widely between exosome sources. Although exosomes have plenty of scientific properties, they’re not yet considered biotherapeutics or diagnostic platforms by the Food and Drug Administration (FDA). 

This is because it’s critical to target therapeutic exosomes selectively to cancer cells when employing exosomes to treat cancers, for example. Many applications need researchers to load a novel medication, protein, or RNA into exosomes to impart a therapeutic effect. Apart from the difficulties inherent in the large-scale manufacture of exosomes, the limited capacity of natural exosomes has hampered exosome translational progress. 


Fortunately, various biotechnological techniques have resulted in establishing a new discipline known as engineered exosomes. Studies show promising results when it comes to improving musculoskeletal health. Recent advances in exosome engineering have enabled the construction of highly specialized exosomes. Note that although exosomes have made significant progress in biomedical research, their use as therapeutic agents is still not considered a feasible possibility. 

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