Novel Therapeutic Applications of Stem Cell-Derived Exosomes in Enhancing Neurological Regeneration and Repair

Exosome-based therapies have emerged as a promising frontier in the field of regenerative medicine, particularly for neural repair. Exosomes, which are microvesicles derived from mesenchymal stem cells (MSCs), neural stem cells (NSCs), and induced pluripotent stem cells (iPSCs), exhibit significant regenerative potential. This manuscript aims to explore the therapeutic prospects of exosome-based treatments in neural injury and neurodegenerative conditions. Recent advancements have deepened our understanding of exosome cargo, including microRNAs (miRNAs), proteins, and growth factors, which are critical to their regenerative capacity. Exosomes operate at various levels to support neuroprotection, enhance axonal growth, promote synaptic plasticity, and modulate immune responses. This paper further discusses the efficacy of exosome treatments, highlighting ongoing and recent clinical studies that investigate the therapeutic benefits of exosomes, particularly through intranasal and intravenous administration routes. Despite their potential, several challenges remain, notably in the large-scale production, distribution, and immune compatibility of exosome-based therapies. This review also addresses future directions for enhancing exosome targeting within neural tissues, with a focus on bioengineering strategies to improve treatment precision. While exosome therapies hold promise for addressing neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and stroke, further research is needed before they can be fully integrated into clinical practice.