title: Acellular approaches for regenerative medicine: on the verge of clinical trials with extracellular membrane vesicles?
abstract: Extracellular vesicles (EVs) are a heterogeneous population of naturally occurring secreted small vesicles, with distinct biophysical properties and different functions both in physiology and under pathological conditions. In recent years, a number of studies have demonstrated that EVs might hold remarkable potential in regenerative medicine by acting as therapeutically promising nanodrugs. Understanding their final impact on the biology of specific target cells as well as clarification of their overall therapeutic impact remains a matter of intense debate. Here we review the key principles of EVs in physiological and pathological conditions with a specific highlight on the most recently described mechanisms regulating some of the EV-mediated effects. First, we describe the current debates and the upcoming research on EVs as potential novel therapeutics in regenerative medicine, either as unmodified agents or as functionalized small carriers for targeted drug delivery. Moreover, we address a number of safety aspects and regulatory limitations related to the novel nature of EV-mediated therapeutic applications. Despite the emerging possibilities of EV treatments, these issues need to be overcome in order to allow their safe and successful application in future explorative clinical studies.
authors.affiliation: Department of Clinical Neurosciences; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Clifford Allbutt Building-Cambridge Biosciences Campus, Hills Road, Cambridge, CB2 0PY, UK. af541@cam.ac.uk.
authors.forename: Almudena
authors.initials: A
authors.lastname: Fuster-Matanzo
authors.affiliation: Department of Clinical Neurosciences; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Clifford Allbutt Building-Cambridge Biosciences Campus, Hills Road, Cambridge, CB2 0PY, UK. fag21@cam.ac.uk.
authors.forename: Florian
authors.initials: F
authors.lastname: Gessler
authors.affiliation: Department of Clinical Neurosciences; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Clifford Allbutt Building-Cambridge Biosciences Campus, Hills Road, Cambridge, CB2 0PY, UK. tl344@cam.ac.uk.|The EMBL-European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SD, UK. tl344@cam.ac.uk.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Leonardi
authors.affiliation: Department of Clinical Neurosciences; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Clifford Allbutt Building-Cambridge Biosciences Campus, Hills Road, Cambridge, CB2 0PY, UK. ni238@cam.ac.uk.
authors.forename: Nunzio
authors.initials: N
authors.lastname: Iraci
authors.affiliation: Department of Clinical Neurosciences; Wellcome Trust-Medical Research Council Stem Cell Institute, University of Cambridge, Clifford Allbutt Building-Cambridge Biosciences Campus, Hills Road, Cambridge, CB2 0PY, UK. spp24@cam.ac.uk.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pluchino
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D004337:Drug Carriers; D000067128:Extracellular Vesicles; D006801:Humans; D044968:Regenerative Medicine / Q000639:trends
chemical_list: D004337:Drug Carriers