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CSTC-Exo is an investigational exosome-based therapy derived from SARS-CoV-2-specific T cells. These exosomes are isolated from the plasma of patients who have recovered from mild COVID-19 and contain viral genome fragments, proteins, peptides, and other virus-related components. The therapeutic rationale is that these exosomes can stimulate an effective immune response in recipients by delivering their cargo to target cells. Mechanistically, CSTC-Exo may reactivate resting or exhausted T cells, restore immune function, and stimulate B-cell responses through the delivery of RNAs and proteins that induce cytokine release and immune activation. There is also a proposed strategy to load these exosomes with miRNAs targeting ACE2 mRNA to downregulate ACE2 expression on host cells—potentially reducing viral entry. Clinical trials (e.g., [NCT04389385](https://clinicaltrials.gov/ct2/show/NCT04389385)) are evaluating inhaled CSTC-Exo for early-stage pulmonary disease in COVID-19 patients to control disease progression and reduce mortality risk[1][3][7][8].
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