TABLE 1.
Advantages and disadvantages of exosomes from different stem cells.
| Origin of exosomes | Advantages | Disadvantages | References |
| MSC | Most studied, well isolated and purified | Low number of endogenous MSCs, and the constantly diminishing number of isolatable MSCs found in the aging individual | Phinney and Pittenger, 2017 |
| CPC | CPCs are specialized to function in the heart, CPC derived exosomes may be particularly well suited to treat cardiac pathologies | Impractical to obtain a sufficient amount of CPCs from the limited amount of available heart tissue | Xiao et al., 2016 |
| ADSC | Readily accessible by routine liposuction, higher number of stem cells can be harvested from adipose tissue | A consensus in the doses of exosomes has not been reached, and the related studies are inadequate and limited. The organ diseases that can be effectively treated by ADSC-Exos are limited. | Hong et al., 2019 |
| CDC | Acellular and non-replicating, facilitating the development of a stable and reliable “off-the-shelf” product, less immunogenic | Low number of endogenous CDCs, need to isolated from the human heart | Gallet et al., 2017; Marban, 2018 |
| ESC | Qualified exosomes can be obtained infinitely from ESCs; Capable of instigating cell analogous response in target cells. | Ethical issue: human embryos are destroyed during the process of harvesting embryonic cells, this makes the research unpopular with those that believe human life begins at conception and that this life is being destroyed | Pessina and Gribaldo, 2006; Chen et al., 2019 |
| iPSC | iPSCs have emerged as a promising alternative to ESCs; readily accessible, possibilities of large-scale production, stability after cryostorage without loss of function and can be applied to personalized medicine. | Laborious and inefficient isolation techniques same as the isolation from other stem cells | Menasche, 2018 |
| iCMs/iECs/iMSCs/iPgs | Generated from patient-specific iPSC-derivatives and can be used for an autologous therapy by activating endogenous repair. | Inefficient purity of iPSC-derivatives and exosomes isolation | Bian et al., 2019 |
ADSC, adipose-derived stem cells; CDC, cardiosphere-derived cells; CPC, cardiac progenitor cells; ESC, embryonic stem cells; iPSC, induced pluripotent stem cell; iCMs, iPSC-derived cardiomyocytes; iECs, iPSC-derived endothelial cells; iMSCs, iPSC-derived mesenchymal stem cells; iPgs, iPSC-derived cardiovascular progenitors; MSC, mesenchymal stem cells.