Journal September 25, 2026 5 min read

Common misconceptions about exosomes

Exosomes are extracellular vesicles, not a single therapeutic agent. This article examines common misconceptions and the research evidence on their roles in disease models.

peptides-pro Editorial

What are exosomes?

Exosomes are a subclass of extracellular vesicles (EVs), typically 30–150 nm in diameter, released by cells upon fusion of multivesicular bodies with the plasma membrane. They carry proteins, lipids, and nucleic acids and are identified by markers such as CD9, CD63, and CD81. In the research literature, they are also referred to as small EVs or exosome-like vesicles. Unlike synthetic nanoparticles, exosomes are biological products with heterogeneous cargo.

Research on exosomes often centres on their role in cell–cell communication via receptor-mediated uptake and cargo transfer, with pathways such as EGFR signalling and AMPK/mTOR frequently implicated in functional studies.

Research Studies

Exosomal hsa-miR-221-5p and keratinocyte LL-37 in melanoma progression

In melanoma, tumour-derived exosomes were found to suppress the expression of the antimicrobial peptide LL-37 in adjacent keratinocytes. This suppression was driven in part by exosomal hsa-miR-221-5p through impaired sustained EGFR signalling. Functionally, keratinocyte-derived LL-37 curtailed melanoma cell migration, invasion, and epithelial–mesenchymal transition (EMT), restrained tumour growth in vivo, and was associated with a tumour immune microenvironment enriched in M1 macrophages [2].

FGF21-modified ADSC exosomes and fibroblast glycolysis in wound healing

Adipose-derived mesenchymal stem cells (ADSCs) engineered to overexpress fibroblast growth factor 21 (FGF21) released exosomes enriched with FGF21 (Exo@FGF21). These exosomes promoted wound healing by activating fibroblast glycolysis through AMPK/mTOR signalling in in vitro and in vivo models [3].

Cerebrolysin-treated endothelial cell exosomes and endothelial permeability

Exosomes released by cerebrolysin-treated cerebral endothelial cells (Cerebro-Exos) showed distinct cargo profiles compared to naïve exosomes, with enrichment in metabolic and tight junction-related proteins. In an in vitro endothelial permeability assay, Cerebro-Exos were superior to naïve exosomes in restoring endothelial cell integrity impaired by fibrin or tissue plasminogen activator (tPA) [4].

Urinary exosome podocyte markers in diabetic kidney disease

A clinical study is investigating podocyte-specific injury markers (nephrin, podocalyxin, and Wilms' tumour protein) in urinary exosomes from African American veterans with albuminuric stage 2 and 3 chronic diabetic kidney disease. The study compares treatment with empagliflozin, finerenone, or combination therapy, and will correlate exosome-based markers with standard biomarkers of kidney injury (urine albumin/creatinine ratio and estimated GFR) and systemic inflammatory markers (IL-1, IL-6, IL-12, hs-CRP) [1].

Neuronal exosomes as biomarkers for exercise effects

A clinical study aims to examine the brain-based biological mechanisms by which exercise exerts anxiolytic effects. The investigators will measure brain-derived markers of mitochondrial metabolism (acetyl-L-carnitine) and inflammation (interleukin-6) using technology to isolate neuronal exosomes [7].

Exosomes in regenerative medicine for neuropathic pain

A review discusses regenerative medicine approaches to craniofacial and corneal neuropathic pain, highlighting the potential of exosome-based therapies for structural nerve repair and functional restoration, though clinical translation remains early [6].

Umbilical cord blood-derived stem cells and exosomes in autism spectrum disorder

A 12-month clinical study is testing whether AdiaVita (umbilical cord blood-derived stem cells and exosomes) plus glutathione improves autism symptoms more than glutathione alone in children ages 3–12. The study randomises about 100 children to receive either monthly IV AdiaVita plus IV glutathione for 3 months or IV glutathione plus saline placebo for 2 months, with both groups also using a topical glutathione spray. Symptoms are tracked using the Autism Treatment Evaluation Checklist (ATEC) [5].

Wharton's jelly exosomes with bone marrow cells in liver cirrhosis

A clinical study is using autologous bone marrow-derived mononuclear cells combined with Wharton's jelly exosomes (20 billion per dose) administered intravenously to stimulate hepatic cell repair in patients with liver cirrhosis, excluding those with active tumour or other major health issues [8].

CAF-derived exosomes and gemcitabine resistance in pancreatic cancer

Cancer-associated fibroblasts (CAFs) contribute to pancreatic cancer progression and therapeutic resistance. A study investigated whether CAF-derived exosomes promote pancreatic cancer cell stemness and gemcitabine resistance by delivering Snail and regulating the SOCS6/HIF-1α axis [9].

Chitosan hydrogel with MSC exosomes in porcine wound model

A chitosan hydrogel loaded with mesenchymal stem cell-derived exosomes significantly accelerated wound closure and enhanced tissue regeneration in a full-thickness porcine skin defect model, while retaining antibacterial properties [10].

LL-37 and ADSCs in diabetic wound repair

A study investigated the combined treatment of LL-37 and adipose-derived stem cells (ADSCs) in diabetic wound repair, focusing on NRROS-mediated crosstalk between TGF-β/SMAD and Hippo/TEAD1 axes [11].

GE11-functionalized exosomes for EGFR-targeted delivery in glioma

Surface-engineered exosomes functionalized with GE11 were developed for EGFR-targeted delivery of peonidin to suppress SNAI1-mediated epithelial–mesenchymal transition in glioma [12].

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