Exosome Evidence Index

How this index works

An entry is included when it is a peer-reviewed report of exosomes or other extracellular vesicles, from human or plant cells, given to people as a treatment. Results posted on a government trial registry are also included and marked “Registry results,” because they are sometimes the only public report of a safety problem. Animal studies, lab studies, and company press releases are left out, as are “conditioned media” or “secretome” products, which contain everything the cells released rather than isolated vesicles. Conference abstracts are not entries, but where one fills in a missing detail for a published trial, the entry says so.

Each study is placed on the ladder by its design: a single case or case series, a study without a control group, a controlled trial, a phase 3 trial with published results, or FDA approval. The result label reflects what the study found compared with its control. When there is no control group, the label says so, because improvement without a comparison can come from the passage of time, other treatments, or the placebo effect.

This index currently lists 27 entries and is growing. A 2025 systematic review counted 25 published clinical trials of cell-derived vesicles through September 2024, and new trials keep appearing. Last updated October 2026.

How to read the bars and marks

Bars: how strong the study design is

More filled bars means a design that can tell more reliably whether the treatment caused the result.

  • Single case or case seriesOne patient or a handful, described without a comparison. It can raise an idea; it cannot show that a treatment works.
  • Study without a control groupA group was treated and followed, but nobody was left untreated for comparison. Improvement may come from time, other care, or the placebo effect.
  • Controlled trialTreated patients were compared with a control: placebo, another treatment, or the untreated side of the face. Most exosome trials at this level are small and short.
  • Phase 3 resultsA large trial designed to prove a treatment works, the kind regulators usually require. No exosome product has published phase 3 results.
  • FDA approvedThe FDA has reviewed the evidence and approved the product for that use. No exosome product is approved for any use.

Marks: what the study found

A solid mark means a benefit over the comparison. Hollow or partly filled marks mean less.

  • Better than controlThe treated group did better than the comparison group on the main measures.
  • Mixed or short-lived resultSome benefit, but only on some measures, in a subgroup, or for a short time.
  • Similar to comparison treatmentAbout the same as another treatment, such as PRP, which may itself be unproven.
  • No benefit over controlThe treated group did no better than placebo or the comparison.
  • Improvement reported, no control groupPatients improved, but without a comparison group there is no way to tell whether the treatment caused it.
  • Safety onlyThe study looked for harms. It was not designed to show whether the treatment works.
  • Stopped for a safety eventThe study was halted after a serious problem in a participant.
  • Trial underway, no results yetA trial has started, but no results have been published.

Systematic reviews used