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An overview of future developments of exosomes in cell-free therapies: a review article
Seyed Khalil Pestehei, Mahdieh Ghiasi, Seyed-Hassan Emami-Razavi ,
Volume 81, Issue 7 (October 2023)
Abstract
Human mesenchymal stromal cells are multipotent cells capable of differentiating into the mesenchymal lineage that can be isolated from bone marrow and adipose tissue or from umbilical cord blood and fetal tissues. Among the widely characterized in vitro properties, MSCs show strong anti-proliferative and anti-inflammatory effects on immune responses Exosomes derived from mesenchymal stem cells derived from different tissues are promising cell-free treatments for tissue damage repair. Exosomes serve as a potential portal for cell-free drug delivery systems, as these drugs possess the properties of the parent cell from which they are derived. Extracellular vesicles (EVs) play key roles in cell biology and may provide new clinical diagnostics and therapies. Exosomes, called extracellular vesicles (EcVs), are present in almost all cells, tissues, and body fluids. They contribute to intercellular signaling and maintain tissue homeostasis. The biogenesis of exosomes starts in the endosomal system. Researchers have identified 9769 proteins, 2838 miRNAs, 3408 and 1116 lipids present in exosome of mRNA cargo. Isolation of exosomes from cells, tissues and body fluids follows a different pattern. Exosomes interact with receptor cells through their surface receptor molecules and ligands and are internalized into receptor cells through micropinocytosis and phagocytosis. This varies depending on the origin of the EV, its physiological and pathological state, and even the exact site of cellular release. The composition of the protein inside can also indicate the presence of disease pathologies such as cancer or inflammatory diseases; However, exosomes also contain a number of common proteins as well as proteins involved in vesicle formation. Advanced technologies in regenerative medicine have caused researchers to use exosomes isolated from mesenchymal stem cells (MSCs) with high regeneration ability in diseases. Exosome cargo plays a key role in diagnosis and treatment by controlling the disease process. Various studies in laboratory conditions have shown the effectiveness and therapeutic potential of exosomes in cancer, neurodegenerative, cardiovascular and orthopedic diseases. This article describes the therapeutic role and potential of exosomes derived from mesenchymal stem cells, as well as the necessary precautions for their processing.

Assessment of studies on the use of platelet-rich plasma in shoulder tendinopathy: a review article
Nima Bagheri, Mahdieh Ghiasi, Khalil Pestehei,
Volume 82, Issue 4 (July 2024)
Abstract
Tendon ruptures may occur as a result of acute injuries or degenerative changes in the tendons caused by aging, excessive and long-term use of the shoulders, and sudden wear and tear. This tear may be partial or completely separate the tendon from its attachment to the bone. Rotator cuff tendinopathy of the shoulder is one of the common causes in patients that affect the daily performance and quality of life. Tendinopathy problems are one of the most common problems of people who refer to medical centers, and in some people, improvement is very important because of their job position. Platelet-rich plasma has received attention due to having growth factors involved in tissue repair in tendinopathy patients. This review study examined the clinical effect of platelet-rich plasma injection in rotator cuff tendinopathy, as well as other studies comparing it with corticosteroids. A literature search was conducted in various scientific databases to obtain articles up to 2022 examining the clinical effects of PRP injection on tendinopathy. Platelet-rich plasma (PRP) is one of the products derived from blood that contains a greater number of physiological platelets. PRP contains a large amount of growth factors such as TGF-β, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which play an important role in cell proliferation, cell differentiation, chemotaxis and angiogenesis. These growth factors are significantly upregulated following tendon injury and are active at different stages of the healing process. Platelet-rich plasma is an autologous source of growth factors and has been shown to be beneficial in the treatment of tendinopathy and osteoarthritis. PRP injection can be recommended as a suitable and desirable method in tendinopathy and rotator cuff tear patients, especially in adults, and can be substituted for corticosteroids. PRP is a minimally invasive treatment method that is used to treat muscle diseases and tendon injuries. In this method, blood is taken from the person, and after that, the components of the blood are separated during a process, and the platelet-enriched plasma is re-injected into the muscles and tendons of the shoulder.

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