Exosomes vs PRP vs Stem Cells vs Vsels

What is Exosomes?

An exosome is a small vesicle produced by a cell that can tell other cells what to do. For example, we can communicate by sending writing notes or by using electronic for instance: email. Exosomes are a type of email that allows one cell to communicate with another. The message could be about how to act or what’s going on in the area.


Intercellular communication through exosomes appears to have a role in the pathogenesis of a variety of diseases, including cancer, neurodegeneration, and inflammatory diseases.

There are at least a few hundred different types of exosomes that can all do different things. The problem we have right now is that no one is clear on how to isolate specific exosomes that code for discrete actions like fixing your cartilage, ligaments, tendons, muscles, or nerves. In addition, not all exosomes are helpful. For example, two exosome types have been identified that are associated with a higher death rate in hospitalized patients

What is PRP?

Diagram showing composition of blood Free Vector

picture from freepik.com

PRP stands for platelet-rich plasma.

Our blood contains small solid components (red cells, white cells, and platelets). Platelets are best known for their role in blood clotting. Platelets also contain hundreds of proteins known as growth factors, which are critical for injury healing.


PRP is plasma that contains much more platelets than normal blood. As a result, PRP is thought to hasten the healing process.


To develop a PRP preparation, blood must first be drawn from a patient. During the centrifugation process, platelets are separated from other blood cells and their concentration is increased. After that, the platelets are injected into the injured area.

Exosomes can be successfully isolated and purified from human PRP.

The exosomes derived from PRP (PRP-Exos) have been proven to encapsulate principal growth factors from platelets. According to a study, these exosomes may have the same function as PRP. PRP-Exos can promote angiogenesis and re-epithelialization in chronic wounds by causing endothelial cells and fibroblasts to proliferate and migrate. 


A study observed the cutaneous healing process in chronic wounds treated with PRP-Exos in a diabetic rat model. They provide evidence of the probable molecular mechanisms underlying the PRP effect on healing of chronic ulcers and describe a promising resource of growth factors from exosomes without species restriction.

What is Stem Cells?

Stem cell Malaysia

The primary purpose of stem cells is to maintain, heal and regenerate tissues wherever they reside in your body. This is a continuous process that occurs inside your body throughout your life. If you didn’t have stem cells, your lifespan would be about an hour, because there would be nothing to replace exhausted cells or damaged tissue. In addition, any time your body is exposed to any sort of toxin, the inflammatory process causes stem cells to swarm the area to repair the damage.

Stem cells differ from other kinds of cells in the body. They are special because of their ability to self-renew, duplicate, regenerate and repair.

Stem Cell Therapy

Stem cell treatment, also known as regenerative medicine, uses stem cells or their derivatives to promote the repair response of damaged, dysfunctional, or wounded tissue. It’s the next step in organ transplantation, and it relies on cells rather than donor organs, which are in short supply.


In a lab, researchers grow stem cells. These stem cells are manipulated to specialize into specific types of cells. And then the specialized cells can be implanted into a person. For instance, if the person has heart disease, these cells could be injected into the heart muscle.

Although their preparation, mechanism and action and efficacy have been shown to be different, studies have shown that both PRP and SC can complement each other and might have an added advantage when used in combination.


For example, PRP offers a suitable microenvironment for MSCs to promote proliferation and differentiation and accelerates wound healing capabilities. Conversely, PRP can be a powerful tool to attract cell populations, such as MSCs, a combination of which provides a promising approach for the treatment.

What is Vsels?

Very small embryonic-like stem cells (VSELs)

The idea behind VSELs is that they are small and like embryonic stem cells, they can differentiate into many different cell types. They are supposed to be produced largely in the bone marrow but can mobilize from there into the blood under certain circumstances.


It is thought that VSELs originate from the early cells in an embryo and are deposited in developing organs as the embryo grows. It’s also thought that they play a role as a backup population for tissue-committed stem cells. There are stem cells that live in all of your organs that help repair things. So the idea would be that if the local stem cells were depleted or couldn’t function, VSELs would step in.


However, there are no clinical data that showed VSELs can treat any human condition. There are no clinical trials or even case series listed in the US National Library of Medicine.


Exosomes vs PRP vs Stem Cells Treatment

a. Exosomes vs PRP Treatment for Hair Loss

Exosome and Hair Restoration | Source: taylorplasticsurgery.com

Both PRP and Exosomes, when injected into the scalp, can make our hair healthier and thicker. Exosomes, on the other hand, are a newer therapy option for hair loss that many researchers suggest is just as effective as or perhaps more effective than PRP.
Exosomes contain some 200+ growth and re-growth factors. They’re recognized for promoting healing, assisting in the regeneration of normal tissue, and a variety of other uses, including hair thickening.

b. PRP-Exos vs Activated PRP for Osteoarthritis

Platelet-rich plasma (PRP) provides a nonsurgical approach for treating osteoarthritis (OA).


In vivo, a study established animal knee OA model by surgery to compare the therapeutic effect of exosomes derived from PRP (PRP-Exos) and activated PRP (PRP-As). Proliferation, migration, and apoptosis assays were measured and compared between PRP-Exos and PRP-As to evaluate the therapeutic effects on OA.


They found that the therapeutic effects of PRP-Exos on OA were similar or better compared with those of PRP-As in vitro or in vivo. PRP-Exos acting as carriers containing growth factors derived from PRP present a novel therapy for OA by activating the Wnt/β-catenin signaling pathway.

c. PRP vs Stem Cell Treatment for Knee Osteoarthritis (KOA)

A study concludes both intra-articular platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) injections are effective in patients with mild to moderate KOA in terms of providing symptomatic relief, restoring physical functionality and improving potential tissue repairment in the affected joints.


PRP treatment works best among patients with KOA Kellgren-Lawrence (KL) grade I-II, while MSCs treatment works best among the KOA KL grade II-III group. Both treatments show minimal effects in patients with severe KOA of KL grade IV.

d. PRP Treatment for Anti Aging

Injection PRP monotherapy was found to at least temporarily induce modest improvement in facial skin appearance, texture, and lines. Fine wrinkles and pigmentation around the eyes may also benefit. Adjuvant PRP accelerated healing after fractional laser resurfacing.  Patients reported high satisfaction despite the fact that the degree of improvement was often less than 50%. 


However, it is unknown how long these effects will last. To improve treatment regimens, more high-quality trials with sufficient follow-up are required.

e. Stem Cell Transplant for Cancer Treatment

Stem cell transplants are treatments that help people who have had their blood-forming stem cells destroyed by high doses of chemotherapy or radiation therapy used to treat certain cancers.  


Blood-forming stem cells are important for our body. The following are the primary types of blood cells:

– White blood cells, which aid in the fight against infection. 
– Red blood cells, which deliver oxygen throughout the body.
– Platelets, which help the blood clot.


Depending on their intrinsic capacities, many stem cell types have been used for anticancer therapy.

Hematopoietic stem cell transplantation, for instance, has proven to be a successful treatment for hematologic cancers such as leukemia, multiple myeloma, and lymphomas.

f. Stem Cell Therapy for Diabetes Mellitus

Majority of stem cell research for diabetes is concentrated on Type 1 diabetes as it can be traced to the loss of a single cell type, the beta islet cell. Beta cells (β cells) are a type of cell found in pancreatic islets that produce and secrete insulin. In patients with type I or type II diabetes, beta-cell mass and function are diminished, leading to insufficient insulin secretion and high blood sugar.

Currently, two approaches are being used in research, using stem cells as beta-cell producing factories or as a beta cell repair catalyst. Both methods have the same goal which is to return the insulin to normal levels. Diabetes Research Institute (DRI) are running clinical trials and have a number of patients that are living insulin free after receiving a transplant of donor islet cells.

Update 2019: A review, published in the Progress in Stem Cell journal suggested a combination of antioxidants, growth factors or hormones along with MSCs (mesenchymal stem cells) in optimal combinations and concentrations for the treatment of diabetic nephropathy.


FDA regulates exosome products. As a general matter, exosome products intended to treat diseases or conditions in humans require FDA approval. There are currently no FDA-approved exosome products.

Currently, FDA only approved stem cell treatments that treat certain cancers and disorders of the blood and immune system.