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   The use of allogeneic mesenchymal stem cells and exosomes obtained from infant cord blood tissue in the treatment of erectile dysfunction is a very current and promising approach. Within the scope of regenerative medicine, stem cell therapies are used in many fields of medicine, especially in neurological and degenerative diseases, and the results obtained in new scientific studies on humans are surprisingly positive. Today, stem cell therapies have moved one step beyond being experimental. Stem cell therapies are now used more frequently in patients with life-threatening conditions and severely impaired comfort of life, as safety concerns have been overcome to a great extent. Before moving on to the use of stem cells in the treatment of severe erectile dysfunction, let us clarify the concept of 'exosome', a new and popular topic.    

Exosomes are small, membrane-enclosed vesicles secreted by cells and play an important role in intercellular communication. Their diameter usually varies between 30-150 nanometres. Exosomes contain various bioactive molecules (such as proteins, lipids, RNA and DNA fragments) inside cells and transport these molecules to other cells. Exosomes are very small molecules, one thousandth the size of a normal cell.

The main features and functions of exosomes are as follows:


            1. Intercellular Communication: Exosomes enable cells to communicate with each other. The molecules they contain can change the functions of target cells and regulate biological processes.

            2. Cell Regeneration and Repair: Exosomes play an important role in the repair of damaged tissues and cell regeneration. Especially stem cell-derived exosomes have great potential in this field.

            3. Immune Modulation: Exosomes can contribute to the regulation of the immune system. This effect may mean both strengthening immune responses and controlling autoimmune responses.

            4. Disease Markers (Biomarker): Exosomes can be used as biomarkers in the diagnosis of various diseases. Exosomes found in biological fluids such as blood, urine and saliva may vary in disease states.

            5. Treatment Carriers: Exosomes can be used as carriers in drug and gene therapies. In this way, therapeutic molecules can be delivered effectively to target cells.

   In addition to their natural and biological functions, exosomes are of great interest in medical research and therapeutic applications. In particular, their potential use in the treatment of various health problems such as cancer, neurological diseases, cardiovascular diseases and erectile dysfunction is being investigated. Even more excitingly, it has been observed that the use of exosomes in combination with allogeneic stem cells may yield better results than when used alone.

Mesenchymal stem cells (MSCs) are versatile cells found in various tissues such as bone marrow, adipose tissue, muscle, cartilage, synovial membranes and umbilical cord. MSCs are of great interest in medical research and therapeutic applications due to their ability to differentiate into different cell types and their immunomodulatory properties.


The main characteristics and potential uses of mesenchymal stem cells are as follows:


1. Versatile Differentiation Capacity: MSCs can differentiate into various cell types such as osteoblasts (bone cells), chondrocytes (cartilage cells), adipocytes (fat cells) and myoblasts (muscle cells). These properties enable their use in tissue engineering and regenerative medicine applications.


2. Immunomodulatory Properties: MSCs have the ability to regulate the responses of the immune system. They can reduce inflammation and can be used in the treatment of autoimmune diseases.


3. Tissue Repair and Regeneration: MSCs can play a role in the repair and regeneration of damaged tissues. Thanks to these properties, their use in post-traumatic healing processes, joint diseases and cardiovascular diseases is being investigated.


4. Paracrine Effects: MSCs can regulate the function of surrounding cells by secreting exosomes and other bioactive molecules. These paracrine effects promote cell survival, proliferation and differentiation.


   MSCs have great potential in the fields of cell therapies and tissue engineering. The use of MSCs in clinical applications is usually subject to specific criteria and regulations and is thoroughly evaluated before being used on patients. In particular, MSCs derived from maternal-infant cord tissue and obtaining and multiplication of Wharton Gel-derived MSCs is technically much faster and easier and does not pose an ethical problem. MSCs, which are grown in appropriate media under special GMP laboratory conditions, are then purified and frozen for storage. Since they are HLA (-), Wharton gel-derived allogeneic mesenchymal stem cells are immunologically safe and do not cause allergic reactions in the recipients. Wharton's gel-derived stem cell suspensions are centrifuged to remove MSCs and pure exosomes can be obtained. Exosomes are products secreted from stem cells but they are not cells. Exosomes can also be obtained from the person's own blood and adipose tissue, but it is thought that neonatal Wharton gel-derived exosomes may be more effective in treatment.



  Exosome therapy in erectile dysfunction is an innovative approach that has been studied in recent years. Exosomes are small vesicles secreted from cells and play an important role in intercellular communication. Thanks to the bioactive molecules they contain, they provide potential benefits in the process of repair and regeneration of damaged tissues.


   The use of exosomes in the treatment of erectile dysfunction is based on the idea that especially stem cell-derived exosomes can help repair damaged cells in penile tissue. This treatment method aims to improve blood flow and nerve function in penile tissue by utilising the anti-inflammatory, anti-apoptotic and tissue regenerating properties of exosomes.


   This treatment is still in the research phase and clinical applications are not yet widespread. However, some early studies and research on animal models show that exosome therapy offers promising results in the treatment of erectile dysfunction. In particular, exosome therapies combined with mesenchymal stem cells can provide successful results in the treatment of severe erectile dysfunction.


   In our clinic, we prefer Wharton gel-derived MSCs and exosomes obtained from accredited and Ministry of Health approved GMP laboratories. Depending on the severity of the erection problem, the number of MSCs and exosomes we will use and the number of cycles may vary according to the patient. The products are prepared in stem cell laboratories the day before, final controls and counts are made and transferred to our clinic with personalised certification. In our clinic, these products are administered as penile injection within 12-24 hours. The patient does not require hospitalisation or rest. The injection procedure is performed under local cream anaesthesia and is completely painless. Exosome suspensions can be stored for 1 week at +4 degrees Celsius, but can also be stored for up to 6 months at -20 degrees Celsius if necessary. MSCs, on the other hand, cannot be stored; they must be applied within 36 hours after leaving the laboratory.



I. Exosomes (5-10 billion) from Whaton's gel (5 ml)

II. Wharton gel-derived (allogeneic) MSCs (10-15-20 million) (10 ml)


  In our patients with moderate to severe erectile dysfunction usually on organic grounds, we apply first exosome and then allogeneic mesenchymal stem cell therapies in combination at one week intervals. Our expectation of clinical improvement after treatment is realised after 3 to 6 months. During this period, PDE5 inhibitor and intracavernosal drug use can be continued. Depending on the benefit, the same procedure can be repeated once again after 6 months. No adverse side effects have been reported to date.

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