Potential Role of Exosomes in Mending a Broken Heart: Nanoshuttles Propelling Future Clinical Therapeutics Forward

Table 3

Comparison of stem cell therapy versus exosomes (cell-free) therapy. Exosomes have several advantages over stem cell transplantation; however, they also have disadvantages for therapeutic applications, which have been outlined in this table.

	References
Cell therapy
Advantages
Potential for multilineage differentiation	[4–8]
iPSCs—potential for autologous transplantation	[4]
Disadvantages
Inconsistent clinical trial results	[114–118]
Low engraftment	[6, 7]
Low direct regeneration	[8]
Risk of formation of benign teratoma	[100, 104]
Fear of tumorigenicity—must pass preclinical in vivo tumorigenicity testing to receive FDA approval	[101–103, 105]
Immunogenicity—rejection of allogenic transplants	[109]
Exosomes (cell-free) therapy
Advantages
Provides active molecules to target cells—mRNA, miRNA, protein	[23–25, 36]
Contents can be modified via source cell manipulation or external means	[119]
Very low immunogenicity	[99, 110]
Disadvantages
Laborious and inefficient isolation methods	[119, 120]
Short-term use only, do not regenerate	[14–116]

iPSCs: induced pluripotent stem cells.