Treating Long COVID with Exosome Therapy

What are Exosomes?

With restorative therapeutics gaining the attention of researchers and clinicians across the world, exosome therapy has been widely recognized as a potential treatment avenue for a range of degenerative conditions and diseases. Exosomes are small vesicles that are secreted by many different types of cells. These vesicles were initially viewed as cellular garbage, but in recent years researchers have discovered numerous clinical applications of exosome properties from drug delivery techniques to restorative therapeutics (41). Exosomes carry numerous biomolecules, such as lipids, proteins, microRNA, and nucleic acids, and deliver this cargo to target cells that subsequently carry out a distinct response based on the contents of the cargo. As such, both exosomes and their contents have the ability to alter cellular communication by influencing the activity of biological processes within tissue microenvironments (41). By expressing target cell-specific surface proteins, exosomal cargo can modulate cellular behavior within target cells with considerable precision.

Many exosome-based therapies contain exosomes that originated from mesenchymal stem cells (MSCs) of the umbilical cord, amniotic fluid, or bone. MSC-derived exosomes are used therapeutically because they mediate changes in biological function by altering gene expression. MSC-derived exosomes carry growth factors and microRNA (mRNA), which is a class of bioactive molecules that can very specifically fine-tune the production of certain proteins that regulate the activity of cellular pathways. By delivering growth factors and mRNA, MSC-derived exosomes can elicit therapeutic effects by enhancing target cell viability and proliferation (41-42). Importantly, MSC-derived exosomes have the ability to regulate the behavior and activity of immune cells (43-44). 

Here at Hudson Medical, we have published several studies on the usage of exosomes in clinical conditions, specifically for inflammatory conditions of the spine. Please read our safety study here. We are continuing with ongoing research with this promising new therapeutic. 

What is Exosome Infusion Therapy and how does it help reduce long COVID Symptoms?

Recently, exosomes secreted by MSCs have been studied as a novel therapeutic tool for the treatment of diseases and conditions ranging from osteoarthritis to chronic regional pain syndrome to long COVID (43-45). MSC-derived exosomal cargo contains several growth factors, cytokines and mRNAs that play significant roles in the regulation of wound healing, tissue regeneration, and immunomodulation (45-51). Each of these bioactive molecules target the activity of cellular pathways that promote tissue regeneration, which is a particularly advantageous property for treatments that target diseases associated with tissue damage or inflammation.

Exosome Infusion Therapy has been studied and used as an option for COVID-related conditions, like lung fibrosis, lung damage, and long COVID. Lung fibrosis can occur as a result of COVID infection and can lead to inflammation or scarring of lung tissue (52). Over 30% of moderate COVID patients experience persistent lung damage up to one year following recovery and an estimated 2-6% of these patients experience lung fibrosis (52). Research has demonstrated that the SARS-CoV-2 virus, the virus that causes COVID, can alter gene expression of lung cells to favor abnormal wound healing processes that can result in the development of lung damage and fibrosis (53). Although traditional treatment options for COVID-induced lung damage are limited to the prevention of further lung tissue damage and symptom relief, Exosome Infusion Therapy has been shown to significantly reduce symptoms of long COVID, including reducing lung inflammation, improving respiratory function, and improving oxygen saturation measurements (54-55). Further, multiple restorative medicine companies which produce exosomes are seeking approval by the Food and Drug Administration (FDA). There are currently several manufacturers of exosomes seeking FDA approval of their exosome products by conducting exosome infusions for long COVID patients who suffered from acute respiratory distress syndrome (ARDS) during an active COVID infection (56). The exact mechanisms by which the SARS-CoV-2 virus causes persistent symptoms in long COVID patients remains unclear, but the regenerative properties of MSC-derived exosomal cargo may in part explain the meaningful reduction in long COVID symptoms following Exosome Infusion Therapy. By modulating cellular communication and regulating cellular physiology, Exosome Infusion Therapy stimulates tissue regeneration and accelerates wound healing, processes that become aberrant in long COVID patients.

What happens during Exosome Infusion Therapy? 

Exosome Infusion Therapy can potentially provide symptom relief of long COVID through the anti-inflammatory and regenerative capabilities of exosomes. When administered intravenously, Exosome Infusion Therapy may address the physiological causes of long COVID symptoms by stimulating tissue regeneration and healing of damaged tissue. 

Exosomes are currently not FDA approved, and are considered experimental. Here at Hudson Medical, we have published several studies on the usage of exosomes in certain clinical conditions. We are currently conducting more clinical trials on this promising new therapy.