Stem cells are unique cells with amazing healing capabilities, it's only been in the last decade that a substantial number of scientists are investigating and providing insights on how to use them most effectively with the help of clinicians having "boots on the ground" actually witnessing the effects and what they're capable of. As well as what concurrent therapies or interventions might increase the stem cells ability to work their magic.
Here is were exosomes come in. Science has recently discovered what actually happens when the endogenous stem cells are deployed in a body joint, or spine. It appears that it's the presence of the stem cells that's most important, not the idea that they just repair damage but that they have a unique signaling system, the "paracrine effect". This is the cell to cell communication that goes on once the stem cells are implanted. One of the most important talking, or signalling messengers molecules are exosomes excreted from the stem cells to the surrounding cells and tissues encouraging them to repair and regenerate. through a complicated process of angiogenesis (formation of new blood vessels) and tissue renewal they appear to be able to improve the promotion of the stem cells.
Although exosomes were discovered over five decades ago, interest among the scientific community didn’t pique until much later. Specifically, in the last ten years, the number of annual publications about exosomes have almost increased by tenfold (from 1,570 published papers in 2007 to 14,000 in 2017).