Autologous Exosome-Enriched Injectable Plasma for Vaginal Regeneration: A Novel Approach and Mechanical Activation
Objectives: Various vaginal rejuvenation techniques have been introduced over the past 10-15 years, and the success of these techniques depends on their capacity to stimulate cellular regeneration. Exosomes are presented as messenger carrier vesicles. Our main focus is to prepare plasma containing a high concentration of exosomes. Traditionally, methods require GMP laboratories to obtain pure exosomes. However, due to practical and cellular limitations, many groups have turned to mechanical activation or bedside methods to prepare exosome treatments.
Introduction: Since the emergence of regenerative medicine, various types of cell therapies have become important treatments in medicine. Exosome treatments have gained popularity over the past five years due to their fast and direct-acting mechanisms. These treatments are mostly carried out by processing cells or mediums in GMP laboratories. Recently, many groups have switched to autologous methods of exosome preparation, rather than lab-prepared exosomes, due to regulatory restrictions and the short lifespan of exosomes.
Materials / method: PRP (Platelet-Rich Plasma) was prepared using PRP tubes to obtain regenerative exosomes from platelets. The Pure PRP (Leukocyte-Poor PRP) isolation method was applied. The purpose of using Pure PRP is to isolate exosomes from platelets, rather than from leukocytes. The harvested PRP was manually processed with specialized devices to induce mechanical stress. To further enhance mechanical stimulation, a special type of striped tube designed to create mechanical stress was used, along with centrifugation. The final product was injected to promote vaginal regeneration.
Results: The final injectable exosome-enriched plasma was administered to patients. Most of the patients received both skin and intravaginal injections. Within three months of follow-up, significant rates of regeneration and tissue repair were observed in all patients. The exosome numbers and sizes were analyzed using NTA (Nanoparticle Tracking Analysis) to assess the quantity and size of the exosomes. The origin of the exosomes was also examined using flow cytometry. Based on their size, the number of exosomes ranged between 10-60 billion, with 99% of these exosomes being platelet-derived.
Conclusion: Exosome treatments offer a promising alternative. Additionally, preparing autologous exosomes at the patient’s bedside results in higher efficiency, as preservation methods such as freezing or lyophilization, which could affect the 3D structure of exosomes, are not applied. Further studies are needed. Nevertheless, these findings and clinical outcomes demonstrate that the autologous exosome isolation technique is a promising and effective tool for preparing an injectable, platelet-derived, exosome-enriched solution under safe conditions, without the need for expensive chromatography technique
