Through traditional medicine, there were diseases and disorders that previously remained untreated or were simply thought to be incurable. Since the discovery of mesenchymal stem cells (MSCs), there has been a flurry of research to develop MSC-based therapy for diseases and disorders. It is now well-known that MSCs do not typically engraft after transplantation and exhibit their therapeutic effect via a paracrine mechanism. In addition to secretory proteins, MSCs also produce extracellular vesicles (EVs), membrane-bound nanovesicles containing proteins, DNA and RNA. The secreted vesicles then interact with target cells and deliver their contents, imparting their ultimate therapeutic effect. Unlike the widely studied cancer cells, the yield of MSC-exosomes is a limiting factor for large-scale production for cell-free therapies. Here we summarise potential approaches to increase the yield of such vesicles while maintaining or enhancing their efficacy by engineering the extracellular environment and intracellular components of MSCs.

通过传统医学，有些疾病和病症以前没有得到治疗，或者被认为是无法治愈的。自发现间充质干细胞（MSCs）以来，已经进行了大量研究以开发基于MSC的疾病和病症疗法。现在众所周知，MSC通常在移植后不移植并通过旁分泌机制显示出其治疗作用。除分泌蛋白外，MSC还产生细胞外囊泡（EVs），包含蛋白质，DNA和RNA的膜结合纳米囊泡。然后，分泌的囊泡与靶细胞相互作用并释放其内容物，从而赋予其最终的治疗作用。与广泛研究的癌细胞不同，MSC外泌体的产量是无细胞疗法大规模生产的限制因素。