Answering reader questions: snorting stem cells, Regenexx, exosomes

One of the most interesting parts of running The Niche is that I get all these questions about stem cells and related matters from readers. I try to answer questions regularly by email, but sometimes the volume catches up with me. For that reason I periodically try to do posts answering such questions, which has the added benefit of answering the questions for the broader readership.

A brain by PET scan. Snorting stem cells or so-called intranasal delivery could land stem cells in your brain with bad consequences or increase the risk of brain infections.

Today I tackle three reader questions paraphrased for simplicity and anonymity. Sometimes the same questions have been asked by multiple readers in various ways and I give those priority. Note that my answers are not meant as medical advice and I’m not a physician. When in doubt talk to your personal doctor.

A clinic is offering intranasal stem cells for my MS as an alternative to IV injections. I don’t like getting shots but I also don’t like inhaling things up my nose, which seems weird in this case. Which is best?

The short answer is neither. So-called intranasal or “snorting” stem cells is a relatively new approach. We don’t know the risks or potential benefits very well. I recently wrote about intranasal stem cells so check that out and consider the potential risks, which should be discussed with your own doctor. My biggest worry as a stem cell biologist about snorting stem cells is that they may end up in your brain and do harm there. This method of administering stem cells could also increase the risk of brain infections.

Finally, also think about things from a common-sense perspective and ask questions such as, “Why would stem cells going in my nose help my MS?” Other readers have asked about intranasal stem cells or exosomes being sold for various conditions that again to me don’t make a lot of common sense. Inhale stem cells into your nose and it’ll help your knee? Really?

I went to Regenexx for joint pain, felt somewhat better for a couple of months, but now I’m back to square one. Is this typical and what should I do now? Go again?

Regenexx has become a well-known brand name in the clinic world, but I’m not convinced it gives a real lasting benefit over placebo. I did a review of Regenexx in October so check that out. I’m fairly skeptical because of a lack of strong, relevant, and long-term clinical data.

My impression is that what you’ve experienced with a transient perceived benefit is not that unusual. If the cells or PRP offered by one of the many Regenexx clinics do help people I believe it is mostly a temporary, anti-inflammatory kind of effect, which I’m not convinced is worth it. Getting many injections from such clinics boosts costs greatly and likely increases potential risks too. As to what to do now, I’d recommend talking to your regular doctor to get their advice.

I’m considering getting exosomes for my arthritis. My friend did and she said she felt it helped for a time. I don’t understand what exosomes are and how they would work? Are they risky?

Exosomes are like little bubbles of cellular “stuff” that bud off of cells into the liquid around them. I think of them as like microscopic water balloons. Instead of water, inside are all kinds of things like proteins, RNA, and even little bits of DNA sometimes. Each kind of cell is going to make somewhat different exosomes with different stuff inside. Exosome research has clinical promise but it’s not ready for clinical use now. Data point toward exosomes from one type of cell telling other cells what to do like a message. These instructions could be helpful for some health conditions but in other cases they could actually do harm. We just don’t have enough data as a field to know how they should be used and what the risks might be yet.

The FDA has said exosomes are a drug so that’s something to keep in mind too. If nothing else the FDA defining them this way is telling us these are complicated little cellular bubbles. It’s good to ask a lot of questions of those selling unproven exosomes and see if their answers pass the smell test. For instance, have you published your data? Do you have FDA approval?

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