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Exosomes overexpressing CD24 (EXO-CD24) are a novel biologic therapy consisting of exosome vesicles engineered to display high levels of the glycoprotein CD24 on their surface. These exosomes are produced by genetically modifying HEK-293-derived cell lines to stably express human CD24, after which the secreted exosomes are isolated and purified. The drug is administered via inhalation. The mechanism of action involves the immunomodulatory properties of CD24, which acts as an immune checkpoint molecule. By binding damage-associated molecular patterns (DAMPs), but not pathogen-associated molecular patterns (PAMPs), and forming a complex with Siglec-10 and HMGB1, CD24 inhibits activation of the NF-kB pathway and suppresses pro-inflammatory cytokine production without impairing anti-pathogen immunity. This selective suppression helps prevent or treat hyperinflammatory states such as cytokine storm in acute respiratory distress syndrome (ARDS), particularly in COVID-19 patients[1][2][3][6][8]. Clinical studies have shown that EXO-CD24 can reduce inflammatory markers and improve clinical outcomes in patients with moderate-to-severe COVID-19-related ARDS when given by inhalation for five days[6][8]. No significant treatment-related adverse events have been reported.
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