Examining Exosome Application

This is part 2 of a 2-part series.

Part 1: An Update on Exosomes

Chernoff says he’s examined the anti-prostaglandin effects exosomes have on migraines by isolating the supraorbital bundles and flooding the sphenopalatine ganglion and occipital nerves with exosomes. The effect was very similar to that achieved with onabotulinumtoxinA (Botox).

To treat aging skin, he says induced inflammation is the homing mechanism for exosomes applied topically.

“We do that either with microneedling, needle radiofrequency (RF), or fractionated CO2, and then apply [exosomes] topically. When done so, we uniformly saw improvements in the tone, quality, clarity of skin with reduction in pore size and fine lines,” he says, noting their results were quantified using a QuantifiCare 3D camera.

For hair treatment, they use exosomes similar to PRP, he says.

“We pretreat the donor area… we flood the follicles prior to placement in the recipient areas, and at 6 months, we were seeing thicker hairs and more of them as compared with the control side.”

In patients with keloid and hypertrophic scars, Chernoff’s research team found that exosomes quell scar recurrence.

“When injecting hypertrophic scars and placing [exosomes] topically after needle RF, we would see a reversion of the scar to a more normal scar,” he says

For keloids, Chernoff excises the scar tissue, floods the bed with exosomes, and if cartilage is visible, uses amniotic membrane grafts to aid in the healing process.

“We know that if we can see hair follicles, we have to treat these hair follicles at the time of excision. If we have a large area, we’re utilizing an amniotic membrane graft to act as a scaffold to help the exosomes stay in place,” he says.

In aesthetic surgery, minimal scarring is key. He is preinjecting incision sites for lip lifts, facelifts, brow lifts, and blepharoplasty and finding less inflammation, less bruising, and faster reepithelization.

“We’re trying to mimic scarless healing as with the axolotl salamander model,” says Chernoff.

The Future of Exosomes

Chernoff says he believes the future holds much promise for the role of exosomes in age management medicine vs corrective medicine.

“We'll see specific exosomal ‘broths’ based upon what a patient’s problems are, where we'll be able to replenish those,” he says.

He sees a future where taking a sample of patient saliva or blood and running diagnostics on their exosome production will allow for very specific forms of therapy.

In addition, genetically engineered exosomes are on the horizon.

“So the entire field of cellular medicine, regenerative therapies, and stem cell therapies, particularly as they relate to exosomes have such a great, great future,” says Chernoff, “and there's a new day dawning in this exciting field.”