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Bone marrow mesenchymal stem cell derived extracellular vesicles (BM-MSC-EVs) are nano-sized membrane-bound particles secreted by bone marrow-derived mesenchymal stem cells. These vesicles include exosomes and microvesicles and carry a cargo of proteins, lipids, mRNAs, and microRNAs that mediate intercellular communication. BM-MSC-EVs convey the immunomodulatory and regenerative properties of their parent cells without the risks associated with live cell therapies. Their mechanisms include modulation of immune responses (e.g., attenuation of excessive inflammation), promotion of tissue repair through regulation of proliferation and apoptosis in endogenous cells, induction of angiogenesis via stimulation of cellular signaling pathways, and potential anti-apoptotic or pro-apoptotic effects depending on disease context[1][3][6]. The product ExoFlo is a clinical-grade preparation used in trials for acute respiratory distress syndrome (ARDS), especially COVID-19-associated ARDS[1][2][6]. Clinical studies have shown safety at tested doses with signals for efficacy in reducing mortality and improving ventilation-free days in moderate-to-severe ARDS[1].
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