6 · Emerging therapies — cellular, gene & innovative
Mesenchymal stem cells (MSC) & derived exosomes
Review — modulators of corneal healing › 6 · Emerging therapies — cellular, gene & innovative › Mesenchymal stem cells (MSC) & derived exosomes
Mesenchymal stem cells (MSC) & derived exosomes
MSC (bone marrow, adipose tissue, cord) and extracellular vesicles (MSC-EV) · fast-moving front
Oxford V (preclinical) · IV (rare human)
Investigational
Future
Mechanism of actionEffect is essentially paracrine (no engraftment): anti-inflammatory signalling (↓IL-1, TNF-α ; ↑IL-10), immunomodulatory, anti-apoptotic, anti-fibrotic; exosomal cargo (miRNA/proteins) promotes keratocyte proliferation and epithelial migration and reduces scarring (↓α-SMA). Hydrogel/microneedle carriers for sustained delivery.
IndicationsBurns, PED, prevention of fibrosis/haze, adjunct to LSCD treatment, stromal regeneration.
Route & dosageInvestigational — eye drops, subconjunctival/intrastromal injection, scaffold/hydrogel. No standardised dose.
Level of evidenceOxford V (mostly preclinical) · Scale: Investigational. The FDA has issued warnings about unproven exosome products.
| FDA / EU MA | No approved corneal product — research/trials only (USA, EU, Asia). |
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Key studies: MSC-exosome microneedles post-burn (ACS Nano 2024) — PMID 39047084 ; adipose MSC exosomes ↓scarring (J Control Release 2024) — PMID 39675062.