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Melatonin-stimulated mesenchymal stem cell exosomes (also known as MT-Exo or Exocue) are a cell-free biologic therapy consisting of extracellular vesicles derived from mesenchymal stem cells (MSCs) that have been preconditioned or stimulated with melatonin. This preconditioning process enhances the therapeutic profile of the secreted exosomes by upregulating specific microRNAs (miRNAs) and proteins with potent anti-inflammatory, anti-fibrotic, and antioxidant properties. Preclinical research indicates that these exosomes can modulate the PTEN/AKT signaling pathway to promote M2 macrophage polarization and inhibit pro-fibrotic factors such as TGF-β and pro-inflammatory cytokines like TNF-α. The therapy is primarily being investigated for the treatment of chronic kidney disease (CKD), diabetic wound healing, renal ischemia-reperfusion injury, and hyperoxic lung injury.
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