Exosomes, a new alternative for the treatment of atopic dermatitis.

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Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory disease of the skin characterized by itching or itching, swelling and redness, which worsens when exposed to allergens, dryness in the environment, sweat, stress, among other factors, affecting the quality of life of the patient. AD can be triggered by genetic factors, epidermal barrier dysfunction, immune mechanisms, or environmental triggers. There are currently several treatments to control AD, but they are very limited and often have side effects. Some treatments include the application of moisturizers, bandages and antihistamines, but other more specialized treatments focus on controlling immune responses, through the effect of topical immunomodulators and immunosuppressants.

This disease has been found to affect the structure of the outermost layer of the epidermis, the stratum corneum, which is the first barrier to the environment. It has been observed that in AD there is an alteration of the immune response, and that the expression of certain genes that are related to the functions of the stratum corneum is also affected. Fortunately, a group of researchers recently discovered the potential of exosomes derived from mesenchymal stem cells (MSC-Exos), as a promising therapy to treat AD, since after a series of studies it was concluded that exosomes have the ability to reduce the inflammation, by reducing the levels of pro-inflammatory cytokines, as well as promoting the repair of the epidermal barrier, by increasing the production of ceramides in the skin, which prevents transepithelial water loss or dehydration.  

Exosomes are extracellular nanoparticles (30-200nm), and they are secreted by most cells, they contain a large number and types of proteins, lipids, DNA and various kinds of RNA such as miRNA. Exosomes mediate intracellular communication through the transfer of their content from cell to cell. There is evidence that MSC-Exos reproduce the functions of the MSC that produce them and therefore have effects similar to those that a cell therapy would have. This is why MSC-Exos have generated great interest as an alternative cell-free therapy, since they reduce risks of immune rejection and are more stable than parental MSCs under certain conditions.

The role of MSC-Exos in increasing the synthesis of ceramides in the skin is not only of interest for the treatment of AD, but is also of great relevance in the use of MSC-Exos as an active component in skin care products. Ceramides are lipids in the skin that help prevent the appearance of fine lines and keep the skin looking firm and hydrated, which is why they have been used as active ingredients in some cosmetics. In summary, MSC-Exos are feasible to be used as part of the treatment of AD, since the effect of MSC-Exos on the increase of ceramides and reduction of pro-inflammatory cytokines, favors the regeneration of the epidermis and the restoration of the stratum corneum. The anti-inflammatory and augmenting effects of ceramides make it possible to use MSC-Exos as an ingredient in dermocosmetic skin care formulations focused on maintaining skin firmness and hydration.

Bibliographic references:

  • Cho, B. S., Kim, J. O., Ha, D. H., & Yi, Y. W. (2018). Exosomes derived from human adipose tissue-derived mesenchymal stem cells alleviate atopic dermatitis. Stem cell research & therapy, 9(1), 187. https://doi.org/10.1186/s13287-018-0939-5
  • Shin, K. O., Ha, D. H., Kim, J. O., Crumrine, D. A., Meyer, J. M., Wakefield, J. S., Lee, Y., Kim, B., Kim, S., Kim, H. K., Lee, J., Kwon, H. H., Park, G. H., Lee, J. H., Lim, J., Park, S., Elias, P. M., Park, K., Yi, Y. W., & Cho, B. S. (2020). Exosomes from Human Adipose Tissue-Derived Mesenchymal Stem Cells Promote Epidermal Barrier Repair by Inducing de Novo Synthesis of Ceramides in Atopic Dermatitis. Cells, 9(3), 680. https://doi.org/10.3390/cells9030680

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