Q&A: Incorporating MSC Exosomes into Clinical Practice

Living in all blood vessels, there's a special type of stem cell called the mesenchymal stem cell (MSC) that sends out signals to promote the healing process when there's an injury or inflammation within the body, according to Edward Park, MD.

“Those signals are called exosomes, and they are how cells communicate,” explained Dr. Park, author of Exosomes: Songs of Healing. “And it turns out, we can harvest them and give them to people to achieve abnormally efficient healing.”

Dr. Park is among the few experts in clinical use of MSC exosomes, a relatively new and growing field. In addition to offering MSC exosome injections at his cosmetic surgery practice in Upland, California, he instructs an online masterclass on the therapy for medical professionals. 

At the Integrative Healthcare Symposium in February, Dr. Park discussed MSC exosomes' clinical applications, including long-COVID, anti-aging, joint pain, and nerve regeneration. We recently followed up with Dr. Park to learn more about his experience with MSC exosomes as well as the therapy’s dosing, costs, risks, and potential future.

Integrative Practitioner: How does MSC exosome therapy differ from stem cell therapy?

Edward Park, MD: Stem cells are about 3,000 microns; they're big. Exosomes are only 100 nanometers. We don't need everything in stem cells, which have DNA, machinery, mitochondria. We really only need the little messages that come from exosomes. 

Cells are somewhat effective, but the problem is they have self-identifying antigens. So, when you take someone else's stem cells within three or four days, they're gone. But during that time, they released a bunch of exosomes. Likewise, people have done PRP [platelet-rich plasma] injections. PRP causes inflammation and brings in stem cells, which then secrete exosomes. With MSC exosomes, we can just cut to the chase and use the exosomes without having that immune incompatibility rejection or the inflammation that comes with PRP.

Integrative Practitioner: How are you using this therapy in your practice?

Dr. Park: I'd say autoimmunity is one of the most practical applications because it's how your body naturally reduces inflammation and regenerates. I have a friend who has Crohn's disease, and she's finding that it’s helping a lot with that and the eye manifestations. We’ve seen good results for people with torn shoulders, hips, knees, and ankles. Sometimes, we do it for poor circulation. A lot of people love it for rejuvenation. It’s also popular for erectile dysfunction and hair restoration.

Integrative Practitioner: How widespread is the therapy?

Dr. Park: I don't really know. There are about seven viable exosome companies right now, and about 12 trials are going through the FDA [United States Food and Drug Administration]. The FDA is keeping track of everything; there are a lot of claims and a lot of variety in the quality, but it is readily available. I've only had experience with one company, which has been quite good and predictable. 

It's important to realize that this is how your body heals naturally. Studies on animals, like mice who are given heart attacks, strokes, or knee damage show strong evidence that it works. And why shouldn't it? It's how Mother Nature already heals you when you get injured. Imagine that healing and then multiply that by 100. That's what we're talking about.

Integrative Practitioner: How expensive is the therapy?

Dr. Park: It can range from a few hundred bucks for a facial treatment, for instance, to several thousand. In my practice, it's based on the quality. I'm comfortable with most of the techniques, so if you buy enough, we can do multiple regions simultaneously.

Integrative Practitioner: What does the dosing look like?

Dr. Park: This is a kind of an esoteric field. It's not like insulin, where a little bit is not enough, and a lot will kill you. Your body is constantly bathing in MSC exosomes. They used to talk about it in terms of billions, but it's very hard to quantify. There's a machine that quantifies them, but the problem is that most manufacturers make claims about particles, which are not exosomes. 

Roughly, to answer your question, for an individual hand tendon, maybe one billion is enough. Or for injecting the gums for dental abscesses, one billion is good. If you're doing a face, maybe two to three billion. If you're doing a knee, maybe three to five billion. If you're trying to get autoimmune stuff down, maybe five to ten billion. It just depends. I have a guy who takes 24 billion every month who says he feels like he’s getting younger at 77. 

Integrative Practitioner: Is this a one-time injection, or does it need to be done consistently to work?

Dr. Park:  That's a good question. Think of it like this: as people go through life, it's usually a one-way journey to increased disease and dysfunction. For instance, if you're a runner, you might say, ‘I ran through the pain, but as I got into my 50s and 60s, it didn't hurt anymore.’ That’s because the thing just ruptured. 

So, to answer your question, it's a permanent effect. Let’s say you have only 20 percent cartilage left in your knee, and it goes to 35 percent. You may not feel pain and think you're good, but it's not 100 percent; it's not back to full-thickness cartilage. In that case, you either have to decide that it didn't work or that you need to keep repeating it. I liken it to cleaning your bathroom. The bathroom got dirty again, but it's not like the bathroom cleaning didn't work. Or repairing your car, just because you fix a flat tire doesn't mean you won't get a flat on the other side.

I was just in Hawaii, treating nine patients, seven of whom were repeat patients. Most of them were not treating the same area again; they say, 'Well, you fixed my shoulder, come fix my knee.’ For some people, the ability to have something that can fix a chronically damaged and not repairing area is a blessing. For other people, that’s not the case. I treated a very wealthy man whose shoulder only got 25 percent better, and he said, ‘This stuff doesn't work.’ He had a 70-something-year-old shoulder after a lot of sports injury; it's about expectation. If you have something that can help, you should be willing to do it repeatedly. The short answer is that it is permanent, but then rust never sleeps, and you're constantly getting more damage.

Integrative Practitioner: What are the risks of the therapy?

Dr. Park: There are risks of infection based on sterile technique and the host factors, but that's pretty rare. Only with one in 2,000 treatments have I seen an infection. One of the weird risks is that people need to adjust their meds. Let's say your arteries get softer; you might need less blood pressure meds, or else you'll be dizzy standing. Or you might need less thyroid medication because your thyroid came back online. There are many types of unintended consequences when you rub the lamp.

In excess, it can be immunosuppressive. About one in 20 people will get a cold sore because the immune system goes from surveillance to regeneration. So, we warn people about that, and they get some Valtrex, but that's really about it. However, you do want to be careful with people who are immunocompromised.

Integrative Practitioner: Why did you choose to talk about exosomes at the symposium? What were you hoping practitioners would walk away with?

Dr. Park: My hope was to let doctors get more comfortable with it and start experimenting on themselves, friends, and family. I want to get the word out because you never know when it will be FDA-approved or FDA-rejected. Right now, have this window in which people can get improvements.

I've treated my son, who has low-level myocarditis after vaccination, and it helps every time. My mom has gotten 35 treatments, and she has no real aches and pains even though she's a rheumatoid arthritis sufferer. At 86, she's running around with her car driving around, functioning very well. So, she's a big believer. 

I’m just trying to spread the good news that there is something that can remediate a lot of these diseases of aging and chronic illness. Most of what we do in medicine is, of course, mitigating and treating symptoms. And then those meds beget other symptoms, which turns into this endless chase of trying to put out fires that you're helping create. So, this is kind of the most natural way to heal, but in a more efficient and predictable manner.

Editor’s Note: This interview was edited and condensed.