Mesenchymal stem cells and their derived exosomes in multiple sclerosis disease: from paper to practice

We review the cell-based pathophysiology of MS to provide a firm basis for understanding of the processes involving MSCs and their exosomes in MS treatment.MS is an autoimmune neurodegenerative disease targeting the CNS.MSCs considered as promising therapeutic essence in MS with their cell-cell contact, paracrine and differentiation abilities.We review the properties of exosomes, a component of the MSC secretome.We highlight the potential of MSC-derived exosomes as a novel therapy for MS and clarify the differences between MSC-based and exosome-based therapies. Multiple sclerosis (MS) is a chronic neurodegenerative, inflammatory, and demyelinating disease of the central nervous system (CNS). Current medicines are not sufficient to control the inflammation and progressive damage to the CNS that is known in MS. These drawbacks highlight the need for novel treatment options. Cell therapy can now be used to treat complex diseases when conventional therapies are ineffective. Mesenchymal stem cells (MSCs) are a diverse group of multipotential non-hematopoietic stromal cells which have immunomodulatory, neurogenesis, and remyelinating capacity. Their advantageous effects mainly rely on paracrine, cell-cell communication and differentiation properties which introduced them as excellent candidates for MS therapy. Exosomes, as one of the MSCs secretomes, have unique properties that make them highly promising candidates for innovative approach in regenerative medicine. This review discusses the therapeutic potential of MSCs and their derived exosomes as a novel treatment for MS, highlighting the differences between these two approaches.